Infrahyoid myocutaneous flap for reconstruction in head and neck cancer patients.

Abstract

Background: Reconstruction of head and neck defects following tumor excision is one of the most challenging surgeries due to multiple reasons, such as associated cosmetic and functional impairments. The three-dimensional aspect of the defect makes it more difficult. Although in modern settings, microvascular surgery is preferred in many conditions, it requires the presence of resources and expertise. Locoregional flaps are workhorse flaps in head and neck reconstruction. In this article, we present an uncommonly used flap with high acceptability and success rate in head and neck reconstruction.

Aim: To find outcomes of using infrahyoid flap reconstruction in head and neck defects following cancer excision.

Materials and methods: The retrospective study was conducted in the surgical oncology department of our institute. Patients with squamous cell carcinoma of the oral cavity, clinically T1-T3 and N0-N1 stage, with anticipated defects of small to medium defects were included in the study. The study was conducted from July 2020 to June 2022, including a follow-up of 1 year. A total of 14 patients were included in the study. All patients had squamous cell carcinoma of the oral cavity involving different subsites. Patients were operated on by a single surgeon, using the same technique.

Result: A total of 14 patients were included with a male-to-female ratio of 11:3 and age between 45 and 60 years. None of the patients underwent revision surgery, and none of the patients had total flap loss. Four patients had minor flap complications, of which three patients had partial, superficial skin necrosis of the flap which was managed conservatively and epithelized later. None of the patients developed major complications, oro-cutaneous fistula, or radiation necrosis. None of the patients developed recurrence after 1 year of surgery.

Conclusion: The infrahyoid myocutaneous flap (IHF) is a fairly reliable and easy-to-perform flap for small- and medium-sized defects of the oral cavity, without requiring additional incisions and donor site reconstruction.