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VEIN PRESERVATION STRATEGIES TO IMPROVE THE SURVIVAL RATE OF THE INFRAHYOID MUSCULOCUTANEOUS FLAP
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  • Khoi Nguyen,
  • Tham Ngo,
  • Can Nguyen,
  • Richard Wein
Khoi Nguyen
Pham Ngoc Thach University of Medicine
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Tham Ngo
Oncology Hospital Ho Chi Minh City
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Can Nguyen
Oncology Hospital Ho Chi Minh City
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Richard Wein
Tufts University School of Medicine
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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