The blood supply of the sternocleidomastoid muscle and its clinical implications.

BACKGROUND: The knowledge of the exact anatomy of the sternocleidomastoid (SCM) muscle and its nerve and blood supply must be considered a basic prerequisite for its use as a pedicle muscle flap. OBJECTIVE: To give an exact description of the courses and variability of all vessels supplying the SCM muscle. DESIGN: Anatomic analysis of all arteries supplying the SCM muscle. SETTING: The blood supply of the SCM muscle was studied by dissecting bilaterally the anterior regions of the neck of 31 perfusion-fixed human cadavers of both sexes aged 50 to 94 years (mean, 78 years). RESULTS: The blood supply to the SCM muscle can be divided into 3 parts: upper, middle, and lower. The upper third of the SCM muscle was found to be constantly supplied by branches of the occipital artery. According to their courses, these branches are categorized into types 1, 2a, 2b, and 3. The middle third of the SCM muscle receives its blood supply from a branch of the superior thyroid artery (42%), the external carotid artery (23%), or branches of both (27%). In most cases, the lower third of the muscle was supplied by a branch arising from the suprascapular artery (>80%), which has not been described until now. CONCLUSIONS: In contrast to available data, the arterial blood supply of the lower third of the SCM muscle is constantly provided by a branch of the suprascapular artery. Since the SCM muscle flap is used in reconstructive surgery of the neck, the exact knowledge of its blood supply may help to minimize the risk of flap necrosis after surgical procedures.

Attitudes of parents/guardians of mentally retarded former state hospital residents toward current community placement.

Parents/guardians of former state hospital mentally retarded residents were surveyed through a mailed questionnaire to determine their satisfaction with their child's/ward's current residential placement. The vast majority of parents (90.5%) indicated that they were satisfied with their child's community placement and, in fact, preferred it to that of a state hospital placement. This finding, taken with the results of two previous studies (in which investigators found that parents of currently institutionalized mentally retarded persons wanted their child to remain in a state hospital), suggests that parents prefer that their child remain in his or her current placement, whether in the community or a state hospital.