title: Modification of the infra hyoid musculo-cutaneous flap.
abstract: BACKGROUND
  In 1986, Wang described the infra hyoid musculo-cutaneous flap. Here, we report technical adaptations and improvements to this flap.
  
  
  METHODS
  From 1994 to 1996, we performed 61 infrahyoid flaps using the classical procedure. After 5 years of technical evolution, we studied a new series of 91 flaps from January 2000 to June 2002. We reviewed our experience with the infra hyoid flap and described the surgical procedure, its evolution and the impact on the viability of the flap.
  
  
  RESULTS
  In the two series, the main arterial pedicle was usually the superior thyroid artery. Venous drainage was more variable; consequently we always performed a modified neck dissection with preservation of the internal jugular vein. In the first series, the surgical results were good with only seven local complications essentially skin necrosis. The functional and aesthetic results seemed acceptable. In the second series, the results, after technical evolution with better venous drainage and cervical closure, were improved (only one necrosis) and the indications were extended.
  
  
  CONCLUSIONS
  With experience, the infra hyoid myocutaneous flaps is reliable and appears as a particularly useful flap for oral cavity, oral pharynx and pharyngeolaryngeal reconstruction.
authors.affiliation: Head and Neck Surgery Unit, Unité de chirurgie cervico-faciale, Centre Alexis Vautrin, Avenue de Bourgogne, Brabois, 54511 Vandoeuvre les Nancy Cedex, France. g.dolivet@nancy.fnclcc.fr
authors.forename: G
authors.initials: G
authors.lastname: Dolivet
authors.forename: P
authors.initials: P
authors.lastname: Gangloff
authors.forename: J
authors.initials: J
authors.lastname: Sarini
authors.forename: J
authors.initials: J
authors.lastname: Ton Van
authors.forename: X
authors.initials: X
authors.lastname: Garron
authors.forename: F
authors.initials: F
authors.lastname: Guillemin
authors.forename: J L
authors.initials: JL
authors.lastname: Lefebvre
mesh_terms: D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D037981:Neck Dissection / Q000009:adverse effects; D009336:Necrosis; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps / Q000009:adverse effects