Pedicled Infrahyoid Flap Reconstruction for Head and Neck Cancers - an Early Experience in Hong Kong

ABSTRACT

Aim: Head and neck cancer surgeries often result in defects requiring reconstruction. When compared to free flaps, local flaps are associated with shorter operation time, which is preferred in patients with comorbidities and during COVID pandemic with local attrition of anesthetists. Submental flap has a theoretical risk of compromising oncological outcome in level I neck dissection. Alternatively, infrahyoid flap harvest is confined to the central compartment, which is a rare region for lymph node spread. To our knowledge, infrahyoid flap reconstruction has not been reported in Hong Kong. This study aims to evaluate the surgical outcome in patients underwent infrahyoid flap reconstruction at our unit. Method(s) 6 patients (median age 67) who had received infrahyoid flap reconstruction from May2018 to May2022 were retrieved. The primary lesion sites included tongue (4 patients), concomitant retromolar and buccal mucosa (1 patient) and submandibular region (1 patient). The blood supply, dimension of flap skin paddle, flap survival and complications were evaluated. Result(s) The dimension of flap skin paddle was 25 cm2 (range 20- 28). Blood supply was all via superior thyroid vessels. 100% flap survival was achieved in 5 out of 6 patients. Only one patient developed superficial skin necrosis which was treated conservatively. One patient had mild dehiscence of donor site. One patient suffered from disease recurrence and succumbed one year after operation. The other patients are alive up to today. Conclusion(s) In our experience, pedicled infrahyoid flap is a safe and reliable procedure for reconstruction of medium-sized defects after head and neck cancer surgeries.