A case of a 60-year-old male patient with thyroid cancer invading the trachea was presented in the current study. After the initial surgery via a sternocleidomastoid muscle (SCM) clavicular periosteal flap for tracheal reconstruction, the patient experienced flap necrosis. Subsequent debridement and tracheocutaneostomy were performed, followed by a successful repair of the tracheal defect using a platysma myocutaneous flap. The case underscores the critical role of preserving the SCM's integrity to ensure adequate blood supply and reduce the risk of flap necrosis. A staged approach, involving initial debridement and tracheocutaneostomy, followed by secondary reconstruction with a platysma myocutaneous flap, proved effective in managing flap necrosis post-SCM myoperiosteal flap reconstruction. This strategy offers a safe and viable alternative for tracheal defect re-reconstruction.
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