Modified Infrahyoid Myocutaneous Flap by Preserving Muscular Attachments to the Hyoid Bone - A Retrospective Study

The infrahyoid myocutaneous flap (IHF) is one of the flaps used in reconstructive procedures for small- and medium-sized defects in the head and neck. However, the flap has not been widely adopted due to a common perception of unreliability. This study aimed to present a modified technique for IHF reconstruction and to evaluate the outcomes of this modification in comparison with the traditional technique.

A chart review was conducted for all patients who underwent oral reconstruction using the IHF - either by the traditional or modified technique - at a tertiary referral hospital from May 2011 to April 2024. The modified technique involved preserving the muscular insertion to the hyoid bone.

The modified technique with preserved muscular insertion was performed in 26 patients. Of these, only 4 (15.4%) patients developed partial flap loss, and none of the patients experienced total flap loss. All complications were minor and resolved with conservative treatments. This complication rate was lower than that observed with the traditional technique. The drawback of the modified technique was a relatively shorter pedicle length and a smaller skin paddle compared with the traditional approach.

A modification of the IHF that preserves muscular attachments to the hyoid bone may serve as a simplified method to improve surgical reliability.