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. 2021 May 29;6(4):657-660.
doi: 10.1002/lio2.596. eCollection 2021 Aug.

Vein preservation strategies to improve the survival rate of the infrahyoid musculocutaneous flap

Khoi Anh Nguyen  1   2 , Tham Xuan Ngo  2 , Can Quoc Nguyen  2 , Richard O Wein  3
Affiliations

Vein preservation strategies to improve the survival rate of the infrahyoid musculocutaneous flap

Khoi Anh Nguyen et al. Laryngoscope Investig Otolaryngol. .

Abstract

The infrahyoid musculocutaneous flap (IHMCF) is a good alternative in the reconstruction of moderate-sized oral cavity surgical defects. Insufficient venous drainage can significantly affect the survival rate of this flap.

Objectives: Identify the survival rates of the IHMCF and evaluate the functional capacity of reconstructed patients.

Design: We report a case series.

Setting: This study took place at the Department of Head and Neck Surgery of Oncology Hospital Ho Chi Minh City, the largest oncology center in South Vietnam.

Participants: One hundred and twelve patients with surgical defects after oral cavity resection for cancer underwent IHMCF reconstruction from November 2013 to November 2018. During the harvest of the flap, our modification of the surgical technique specifically attempted to preserve more secondary veins for IHMCF.

Main outcome measures: Postoperative viability of the flap was checked by clinical observation. The last examination was performed at 3-months after reconstructive operation or after the completion of adjuvant radiotherapy. The functional capacity of our patients was evaluated by three physicians (Head and Neck Surgeon, Radiation Oncologist, and Physiatrist) with understandability of speech scale and the functional oral intake score items assessed.

Results: Two cases of partial skin necrosis (1.8%) were experienced. The majority of patients demonstrated favorable functional rehabilitation at long-term follow up.

Conclusions: The IHMCF is a reliable flap suitable for moderate-sized defects of the oral cavity. Altering the surgical approach to specifically preserve more venous outflow can improve the survival rate of the flap.

Level of evidence: 4.

Keywords: infrahyoid musculocutaneous flap; oral cavity defect.

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Conflict of interest statement

No conflict of interest.

Figures

FIGURE 1
FIGURE 1
Neck incision: vertically oriented IHMCF at the left side
FIGURE 2
FIGURE 2
The pedicle of IHMCF, the upper purple vein is the communicating vein to the external jugular vein and the lower one is the minor venous tributary to internal jugular vein
FIGURE 3
FIGURE 3
The IHMCF has both the minor venous tributary to internal jugular vein (arrow head) and the communicating vein to external jugular (arrow)
FIGURE 4
FIGURE 4
Patient with right oral tongue reconstruction with IHMCF at 3 months postop
See this image and copyright information in PMC

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