Revisiting the Forgotten Flap-Our Experience of Reconstructing the Oral Cavity in 18 Patients with the Infrahyoid Flap.

Abstract

The frequently overlooked Infrahyoid flap is robust, pliable and an extremely versatile option for reconstruction of small-medium size oral cavity defects. Precarious venous drainage and slightly higher rates of congestion followed by flap loss have led to this flap being side-lined and underutilized. We review our experience of using the infrahyoid flap to reconstruct 18 patients with oral cavity defects following ablative resections for cancers of the oral cavity. In this retrospective analysis, outcomes and complications of 18 patients reconstructed with an Infrahyoid flap for defects created after ablative resection of cancers of oral cavity between June 2019 and May 2022 were studied. 18 patients (14 men and 4 women) were reconstructed with an infrahyoid flap for defects created after resection of cancers of the tongue, floor of mouth and buccal mucosa. Mean age of the study population was 48.33 years. Overall major/minor complications were seen in 38.88% patients. The most common complication recorded was that of partial flap loss seen in 22.22%. Complete flap loss was seen in 2 patients (11.11%) of which one patient developed an Oro-cutaneous fistula. Three patients were assessed to have a partially intelligible speech and one patient presented with restricted tongue protrusion in the post operative period. The easy to harvest infrahyoid flap is a reliable method of reconstructing small-medium sized oral cavity defects. Excellent functional outcomes along with minimal donor site morbidity and acceptable flap related complications makes it a worthy option for reconstructing such defects.