THE NEUROVASCULAR INFRAHYOID MUSCLE FLAP - A NEW METHOD FOR TONGUE RECONSTRUCTION

Objective: Description of a new neurovascular island flap derived from the infrahyoid muscles to reconstruct a total tongue or large defects of the tongue base. The surgical technique, anatomic findings, and th e postoperative function tests with the patients' outcome are describe d. Eleven patients had tongue cancer, 5 at a T-2 stage, 3 at a T-3 sta ge, and 3 at a T-4 stage. Four patients underwent total glossectomy, 3 patients underwent hemiglossectomy, and in 2 patients a half and in a nother 2 patients a quarter of the tongue base were resected. The tong ue of the patients who underwent total glossectomy has been reconstruc ted with the infrahyoid myofascial neurovascular flap from both sides of the neck; in all the other patients this new flap has only been tak en from one side of the neck. In one patient a glossectomy had to be c ombined with a laryngectomy. In 10 patients the tracheostoma could be closed in 4 weeks after the operation, and all patients could eat an o ral diet. Electromyography showed voluntary innervation of the reconst ructed tongues. With the neurovascular infrahyoid flap, defects of the tongue base can be reconstructed successfully after partial resection s or total glossectomies. The main advantage is the voluntary innervat ion of this flap by means of the ansa cervicalis and the prevention of scarring and atrophy of the reconstructed tongue.