Infrahyoid flap reconstruction of oral cavity and oropharyngeal defects in elderly patients with severe general comorbidities

Head Neck. 2012 Sep;34(9):1299-305. doi: 10.1002/hed.21913. Epub 2011 Oct 22.

Abstract

Background: In current practice, surgeons frequently deal with elderly patients who have severe medical comorbidities.

Methods: We present our series of 18 consecutive patients with severe general comorbidities that received infrahyoid flap reconstruction. The results were compared with those of 16 consecutive patients in good general medical state receiving free radial forearm flap reconstruction during the same study period. We also describe an original method for tongue base reconstruction using the infrahyoid flap.

Results: No total flap necrosis was experienced; successful separation between oral cavity/oropharyngeal contents and neck spaces was obtained in all patients with a low rate of general complications. No significant differences were found with regard to verbal intelligibility and diet scores between groups.

Conclusions: Infrahyoid flap in high-risk cases represents a valid alternative to free radial forearm flap. We introduced a novel technical innovation for tongue base reconstruction using the infrahyoid flap with very encouraging results.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Humans
  • Hyoid Bone
  • Male
  • Middle Aged
  • Mouth / surgery*
  • Mouth Neoplasms / surgery*
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps*