Functional Sterno-omohyoid Free Muscle Transfer for Facial Reanimation

Dynamic smile reanimation with functional free muscle transfer is the gold-standard treatment of chronic flaccid facial palsy and congenital facial palsy. Further, it can be used for smile reanimation in patients suffering from severe synkinesis. There are many donor muscles that have been successfully used for facial reanimation, but many have obvious drawbacks. The sterno-omohyoid muscle flap provides tissue that is histologically similar to natural facial muscles, is significantly smaller than many other described flaps, and lends itself to a dual-vector inset and cross-face coaptation for ideal facial reanimation. Herein, the sterno-omohyoid flap is introduced, its pros and cons discussed, and the operative steps of its harvest and inset described.