VEIN PRESERVATION STRATEGIES TO IMPROVE THE SURVIVAL RATE OF THE
INFRAHYOID MUSCULOCUTANEOUS FLAP
Abstract
The infrahyoid musculocutaneous flap (IHMCF) is a good alternative in
the reconstruction of moderate-sized oral cavity surgical defects.
Insufficient venous drainage can significantly affect the survival rate
of this flap. Objectives Indentify the survival rates of the IHMCF and
evaluate the functional capacity of reonstructed patients. Design We
report a case series. Setting This study took place at the department of
Head and Neck surgery of Oncology Hospital Ho Chi Minh City, the largest
oncology center in South Vietnam. Participants We have 112 patients with
defects after oral cavity resection for cancer that underwent IHMCF
reconstruction from November 2013 to November 2018. In the raising of
the flap, our technical approach specifically attempts to preserve more
secondary veins for IHMCF. Main outcome measures Postoperative vitality
of the flap was checked by clinical observation. The last examination
was performed at 1 month after reconstructive operation. The functional
capacity of our patients was evaluated by three doctors (head and neck
surgeon, radiation oncologist, physiatrist) with understandability of
speech scale and the functional oral intake score items. Results Two
cases of partial skin necrosis (1.8%) were experienced. The majority of
patients demonstrate favorable functional rehabilitation at long-term
follow up. Conclusions. The IHMCF is a reliable flap suitable for
medium-sized defects of the oral cavity. Altering the surgical approach
to specifically preserve more venous outflow can improve the survival
rate of the flap. Key words: infrahyoid musculocutaneous flap oral
cavity defect