A Novel Modification of Infrahyoid Myocutaneous Flap for Reconstruction of Oral Cavity Defects

Abstract Purpose This study is intended to describe the technique used and the results obtained with the modification of the infrahyoid flap (IHF) for the reconstruction of oral tongue defects following resection for advanced squamous cell carcinoma (SCC). Methods Patients with oral tongue defects following ablation surgery for T2 to T4a SCC were reconstructed using the modified infrahyoid flap. Demographic data, tumour characteristics, and the complications were evaluated for each patient. Results We observed no complications regarding the healing process of donor site and success of the flap in 49 (of 55 patients) patients. None of the flaps had massive oedema or venous congestion in the post-operative period. Six patients experienced flap-related complications of which 5 had partial skin paddle necrosis but eventually, their flaps recovered and reepithelialised without any further intervention. However, total flap necrosis was seen in one patient in whom pectoralis major flap was used for the defect reconstruction following a revision surgery. History of previous neck radiotherapy (p-value = 0.003), and tumours stage (p-value = 0.017), and metastasis to cervical lymph node (p-value = 0.004) were associated with higher prevalence of partial or total flap necrosis. Conclusion The modified infrahyoid flap is a reliable, quick, and simple procedure with reasonable cost that makes it a valuable option for the reconstruction of the oropharynx and oral cavity with minimal donor site morbidity and good outcomes. It seems the modified IHF is a valid surgical procedure that may be considered in selected oncological patients undergoing reconstruction of oral tongue defects with less complication.