Comparison of the quality of life between patients underwent reconstruction after hemiglossectomy using infrahyoid myocutaneous flap and radial forearm flap / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVEThis study was designed to compare the quality of life between patients who underwent a tongue reconstruction with radial forearm flap (RFF) and infrahyoid myocutaneous flap (IHMCF) after hemiglossectomy for their tongue cancers, and to figure out an optimal reconstructive method for the defects resulted from hemiglossectomy.METHODSA non-randomized case-control study was performed on 24 patients with tongue squamous cell carcinoma who underwent a standard hemiglossectomy combined with perfectly tongue reconstruction from June 2005 to June 2012. All of the cases were without tongue base invasion. Of the 24 cases, 19 had T2 disease, 5 had T3 disease, and they were divided into RFF group (n=10) and IHMCF group (n=14). The quality of life were evaluated one year after operation using EORTC-QLQ30 and FACT-H&N35 and compared between the two groups.RESULTSThe scores were comparable between the two group with regard to all domains of EORTC-QLQ30,with all P values>0.05.The scores of swallowing(P=0.005), speech (P=0.008), teeth (P=0.014), and cough (P=0.009) domains were significantly higher in IHMCF group than in RFF group, with P value of 0.005, 0.008, 0.014 and 0.009 respectively, while the other domains of FACT-H&N35 were comparable between the two groups, with allP values>0.05.CONCLUSIONOverall quality of life was similar in the two groups. Oral function domains were better in IHMCF group than in RFF group. When guarantee of flap survival is available, IHMCF could be used as a good alternative flap to RFF in tongue reconstruction after hemiglossectomy.

Unilateral Absence of the Sternohyoid Muscle with Contralateral Tendinous Belly of Superior Belly of Omohyoid Muscle: A Very Rare form of Infrahyoid Muscle Variation.

The sternohyoid, sternothyroid, thyrohyid and omohyoid constitute the infrahyoid group of anterior neck muscles. All these muscles are supplied by Ansa crvicalis related to the anterior wall of carotid sheath. During regular cadaveric dissection in the Department of Anatomy at AIIMS, Bhubaneswar, a case of right sided absence of sternohyoid muscle with left sided tendinous superior belly of omohyoid muscle was found. Though literature survey shows the tendinous belly (or absence) of superior belly of omohyoid muscle, but its presence in combination with absence of opposite side sternohyoid muscle is hardly reported. The omohyoid muscle has effect on intracerebral venous hemodynamics. Developing from a common muscle primodium the infrahyoid muscle group shows a number of variations. Because of increased use of Infrahyoid myocutaneous flaps for medium sized head and neck reconstruction surgery this knowledge will be helpful for handling and selecting a flap.