title: Infrahyoid myocutaneous flap for medium-sized head and neck defects: surgical outcome and technique modification.
abstract: OBJECTIVE
  To evaluate the surgical outcomes associated with infrahyoid myocutaneous flaps used in the reconstruction of medium-sized defects following head and neck cancer resection, as well as to discuss a novel technique modification.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  University cancer hospital.
  
  
  METHODS
  A total of 20 patients with oral or hypopharyngeal carcinoma who underwent infrahyoid myocutaneous flap reconstruction between June 2005 and December 2011 were retrospectively studied. A novel technical modification of flap harvest, preservation of the cranial portion of the anterior jugular vein, was attempted in 15 flaps and was successful in 13 flaps. Functional evaluation was performed in all patients 3 to 6 months after the operation or postoperative radiation.
  
  
  RESULTS
  Total flap necrosis, marginal skin paddle necrosis, and total skin paddle loss were observed in 1, 2, and 1 patient(s), respectively. Pharyngocutaneous fistula without flap problem occurred in 1 patient. No flap complications occurred in 13 cases where the cranial portion of the anterior jugular vein was successfully preserved. Functional results were excellent in 16 patients, good in 3 patients, and fair in 1 patient.
  
  
  CONCLUSIONS
  The infrahyoid myocutaneous flap is a reliable and convenient technique that can serve as an alternative to free flaps in the reconstruction of medium-sized defects of the oral cavity or hypopharynx. Preservation of the cranial portion of the anterior jugular vein is a novel technical modification of harvesting this flap, which may result in better venous return of the skin paddle and reduce skin paddle necrosis.
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China. penghanwei@126.com
authors.forename: Hanwei
authors.initials: H
authors.lastname: Peng
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Wang
authors.forename: Xihong
authors.initials: X
authors.lastname: Yang
authors.forename: Haipeng
authors.initials: H
authors.lastname: Guo
authors.forename: Muyuan
authors.initials: M
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D011183:Postoperative Complications / Q000503:physiopathology; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D016019:Survival Analysis; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology