Infrahyoid flap—a good substitute for free flaps in oral reconstruction during the COVID‐19 pandemic

Abstract

ObjectiveDuring COVID‐19 pandemic, experts recommended to simplify reconstruction after head neck cancer extirpation by using pedicled flaps instead of free flaps. This will shorten operation duration and obviate free flap failure related to the hypercoagulopathy state of infected patients. We would like to share our experience of using pedicled infrahyoid flap which has not been reported from Hong Kong.MethodsWe retrospectively studied all the patients with infrahyoid flaps reconstruction after oral cavity cancer resection as retrieved from hospital computerized systems. A total of 9 patients were identified and evaluated for demographic and clinicopathologic parameters, as well as oral function and reconstruction outcomes.ResultsOf the 9 infrahyoid flaps, 8 were myocutaneous and 1 were muscle flaps. Flap skin dimension ranged from 24.0 to 46.72cm2. All the flaps survived completely except 1 case that suffered epidermolysis of flap skin which healed uneventfully without orocutaneous fistula. Flap harvest time was about 1 hour. All 9 patients could resume oral feeding with satisfactory speech. Seven patients survived without tumor relapse but 2 other patients succumbed to lung metastases.ConclusionsInfrahyoid flap is a viable alternative to free flap for repairing medium‐sized oral defects in compromised patients and during COVID‐19 pandemic.This article is protected by copyright. All rights reserved.