Infrahyoid fascio-myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction.
BACKGROUND
The use of microvascular free flaps is currently the favored method for the reconstruction of defects after resection of head and neck cancer. The flap most commonly used for head and neck reconstruction is the free radial forearm flap, but the less popular infrahyoid flap represents a good alternative in selected cases. This flap has proven to be helpful in the reconstruction of a wide range of moderate-sized head and neck defects.


METHODS
We reviewed a series of 13 patients with defects resulting from cancer of the head and neck, who underwent infrahyoid flap reconstruction as an alternative to free radial forearm flap. The series includes 12 squamous cell carcinomas arising from the oral cavity and oropharynx, and 1 Merkel cell carcinoma of the submental skin. In the harvesting of the flap, the technical modifications recently suggested by Dolivet et al were used in all cases. Furthermore, another technical change has been introduced so creating a new infrahyoid facio-myocutaneous flap (IHFMCF). The surgical technique is described in detail.


RESULTS
No total or partial flap necrosis was experienced. All reconstructions healed quickly without wound complications and with good functional results. The healing process in the donor site was excellent in every case with good aesthetic results.


CONCLUSIONS
The IHFMCF is a versatile, reliable, and convenient flap suitable for repairing small and medium-sized defects of the oral cavity and oropharynx and obviates the need for a microvascular reconstruction.
Deganello
Alberto
A
Department of Otolaryngology/Head and Neck Surgery, National Cancer Institute, Regina Elena, Rome, Italy. adeganello@hotmail.com
Manciocco
Valentina
V
Dolivet
Gilles
G
Leemans
C René
CR
Spriano
Giuseppe
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection; D009336:Necrosis; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000473:pathology