title: The musculocutaneous infrahyoid flap: surgical key points.
abstract: For the first time in 1979, it was described by Wang that the infrahyoid musculocutaneous flap (IHMC flap) appears to be extremely suitable for medium-sized head and neck defect. Nevertheless, this flap remains unpopular because of its pretended lack of reliability. The aim of this study is to describe the surgical key points and to expose its main advantages. An IHMC flap was achieved on 32 patients to repair tissue loss due to surgical resection of a squamous cell carcinoma of the upper aero-digestive tract, from March 2006 to January 2010. Medical records of each of these patients were retrospectively analysed by the investigators including the detailed clinical, pathological and operative reports. No patient presented with total flap necrosis. However, we experienced four skin paddles necrosis. In two cases, the necrosis was total and in two cases partial. All donor sites were closed primarily without any tension. One patient showed a major dehiscence of the neck skin incision that required a pectoralis major flap. The IHMC flap is reliable and the harvesting technique is simple when the surgical key points are respected. Its advantages make it a convenient flap for medium-sized head and neck defect.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulin, 94800 Villejuif, France. mirghani_fr@yahoo.fr
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Gustavo
authors.initials: G
authors.lastname: Meyer
authors.forename: Stéphane
authors.initials: S
authors.lastname: Hans
authors.forename: Gilles
authors.initials: G
authors.lastname: Dolivet
authors.forename: Sophie
authors.initials: S
authors.lastname: Périé
authors.forename: Daniel
authors.initials: D
authors.lastname: Brasnu
authors.forename: Jean Lacau St
authors.initials: JL
authors.lastname: Guily
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D010369:Pectoralis Muscles / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome