Modification of the infra hyoid musculo-cutaneous flap

Dolivet, Gilles; Gangloff, Pierre; Sarini, J.; Van, J. Ton; Garron, X.; Guillemin, François; Lefebvre, J. L.

doi:10.1016/j.ejso.2004.10.006

Cited by 66 publications

(54 citation statements)

References 5 publications

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“…Multiple aesthetic or functional sequelae are induced. Even if the use of free flaps (free radial forearm flap in particular) or local flaps (pectoralis major flap, temporalis flap, infra hyoid musculo cutaneous flap) can reduce these sequelae [17,18], quality of life remains often perturbed and success rate is low.…”

Section: Discussionmentioning

confidence: 99%

Photodynamic therapy as salvage treatment for recurrent head and neck cancer

Gangloff

Phulpin

Cortese

et al. 2012

Med Buccale Chir Buccale

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-Head and neck cancers often lead to disfiguration or functional impairments after treatment. Local recurrence occurs in around 60% of cases and most of them can not be retreated. Photodynamic therapy (PDT) can be an alternative treatment. In a serie of 10 patients with recurrent squamous cell carcinoma of the head and neck that have failed prior therapies and are unsuitable for conventional curative therapy, PDT treatment has been used. Eight patients have shown complete cicatrisation. Seven patients were cured after the follow up period up to 53 months. Three patients died (one outside etiology). Quality of life was considered as very much for 6 out of 10 patients, quite a bit for 1 patient, a little for 2 patients and not at all for 1 patient. Clinical benefit was evaluated as very much for 6 patients out of 10, quite a bit for 2 patients, a little for 1 patient and not at all for 1 patient. PDT can be proposed to patients with head and neck cancer in palliative situation. It could be a therapeutic solution for selected cases with good outcomes. PDT offers patients a unique chance of remission and increased life expectancy compared with palliative treatments.Résumé -La thérapie photodynamique comme traitement de sauvetage pour les récidives des cancers des voies aéro-digestives supérieures. Les cancers de la tête et du cou conduisent souvent à des séquelles esthétiques ou fonctionnelles majeures après traitement. Des récidives locales sont observées dans environ 60 % des cas et la majorité ne peut pas être retraitée à nouveau. La thérapie photodynamique (PDT) peut être une possibilité de prise en charge alternative. Dans une série de 10 patients présentant une récidive d'un carcinome épidermoïde des voies aéro-digestives supérieures qui n'est plus accessible à traitement curatif conventionnel, la PDT a été utilisée. Huit patients ont montré une cicatrisation complète. Sept patients étaient considérés comme guéris après une période de surveillance allant jusqu'à 53 mois. Trois patients sont décédés (dont un d'une cause extérieure au contexte carcinologique). La qualité de vie a été considérée comme très bonne pour 6 patients sur 10, bonne pour 1 patient, moyenne pour 2 patients et mauvaise pour 1 patient. La PDT est une option thérapeutique qui peut être proposée aux patients atteints de cancers des voies aéro-digestives supérieures et placés en situation de prise en charge palliative. Cela pourrait être une possibilité de prise en charge pour des patients bien sélectionnés qui permettrait d'obtenir de bons résultats. La PDT a offert à ces patients une chance unique de rémission de la maladie et a amélioré indéniablement le taux de survie par rapport à la prise en charge palliative qui était la seule alternative.Key words: head and neck cancer / photodynamic therapy / salvage therapy / photosensitizers / squamous cell carcinoma

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Section: Discussionmentioning

confidence: 99%

Photodynamic therapy as salvage treatment for recurrent head and neck cancer

Gangloff

Phulpin

Cortese

et al. 2012

Med Buccale Chir Buccale

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“…The shape of the flap is rectangular or oval in a vertical position, and the skin paddle must be fitted and included in the incision for unilateral or bilateral neck dissection. In 2005 Dolivet et al [15] introduced a modification for the neck incision proposing an S instead of the original T shaped incision, and this modification was acquired in further reports ( Fig. 1) [8,11,[16][17][18][19][20].…”

Section: Surgical Techniquementioning

confidence: 99%

“…However if none of these features is present and the appearance of the skin is normal, then the flap can be considered [11,15].…”

Section: Limitationsmentioning

confidence: 99%

“…Previous (chemo)radiotherapy is not an absolute contraindication for IHF [5,11,15], but preoperative careful evaluation of the intended skin paddle is recommended: if lack of pliability, radiation induced fibrosis or teleangiectasias are encountered in the cervical skin, then a decrease in blood supply to the skin through the perforator vessels is probably occurring and the flap is contra-indicated. However if none of these features is present and the appearance of the skin is normal, then the flap can be considered [11,15].…”

Section: Limitationsmentioning

confidence: 99%

“…We also used the IHF for intraoral reconstruction together with free fibula osseous mandibular reconstruction, whenever skin perforators for a fibular osteocutaneous harvest were not found or reliable [8]. In literature this flap has been successfully used for defects of the oral cavity and oropharynx [5,8,11,19,25,27,30,31], the parotid region [5], the pharyngolaryngeal tract [8,15,26,27] and the cervical trachea [9]. As a myofascial transposition, it has been used to close iatrogenic pharyngeal [34] and esophageal [35] fistulas following anterior cervical spine surgery, or to prevent fistula formation after total laryngectomy [36].…”

Section: Clinical Utilitymentioning

confidence: 99%

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The infrahyoid flap: A comprehensive review of an often overlooked reconstructive method

Deganello

Leemans

2014

Oral Oncology

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a b s t r a c tThe infrahyoid flap is a myocutaneous pedicled flap mainly nourished by the superior thyroid vessels through the perforators of the infrahyoid muscles. This thin and pliable flap provides a skin island of about 7 by 4 cm from the central part of the anterior neck. The flap can be transferred on its pedicle of superior thyroid artery and vein to reconstruct medium sized head and neck defects created after cancer ablation. We have successfully used this flap in a series of 40 cases with no total flap loss and with 1 case of superficial skin necrosis. The aim of this review is to highlight the clinical usefulness of this pedicled flap even in the microvascular free flap era. A comprehensive review of the available literature reporting on the infrahyoid flap has been carried out using a web search. The history of the infrahyoid flap, the surgical technique with technical innovations, the clinical utility and limitations of this flap, are reported and discussed. Among the 7 larger series (cohort larger than 50 cases) a total of 956 flaps were performed, and the global success rate was 91.7%, with failures being mainly related to partial skin necrosis, as the rate of total (skin and muscle) flap necrosis was only 1%.This flap is reliable, easy to harvest during neck dissection, oncologically safe, it does carry a negligible donor site morbidity. This paper highlights how the infrahyoid flap can represent an excellent reconstructive solution in selected patients and head and neck sites.

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Infrahyoid fascio‐myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction

Deganello¹,

Manciocco²,

Dolivet

et al. 2007

Head & Neck

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Background. The use of microvascular free flaps is currently the favored method for the reconstruction of defects after resection of head and neck cancer. The flap most commonly used for head and neck reconstruction is the free radial forearm flap, but the less popular infrahyoid flap represents a good alternative in selected cases. This flap has proven to be helpful in the reconstruction of a wide range of moderate-sized head and neck defects.Methods. We reviewed a series of 13 patients with defects resulting from cancer of the head and neck, who underwent infrahyoid flap reconstruction as an alternative to free radial forearm flap. The series includes 12 squamous cell carcinomas arising from the oral cavity and oropharynx, and 1 Merkel cell carcinoma of the submental skin. In the harvesting of the flap, the technical modifications recently suggested by Dolivet et al were used in all cases. Furthermore, another technical change has been introduced so creating a new infrahyoid facio-myocutaneous flap (IHFMCF).The surgical technique is described in detail.Results. No total or partial flap necrosis was experienced. All reconstructions healed quickly without wound complications and with good functional results. The healing process in the donor site was excellent in every case with good aesthetic results.Conclusions. The IHFMCF is a versatile, reliable, and convenient flap suitable for repairing small and medium-sized defects of the oral cavity and oropharynx and obviates the need for a microvascular reconstruction. The main goals of modern head and neck reconstructive surgery are adequate wound healing, restoration of function, and appearance. In the preoperative planning, it is crucial to determine which reconstructive procedure will be most suitable for the patient to optimize functional outcome after cancer ablation. As a general rule, an optimal reconstruction should enhance the residual function allowing good motility of the preserved structures around the resected area, guarantee a quick and safe healing process, and provide a restoration of form with acceptable aesthetic results. The application of microvascular free flaps is the most widespread method currently employed for the reconstruction of extensive defects after resection of head and neck cancer because of their versatility and reliability. TheCorrespondence to: A. Deganello

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Modification of the infra hyoid musculo-cutaneous flap

Cited by 66 publications

References 5 publications

Photodynamic therapy as salvage treatment for recurrent head and neck cancer

Photodynamic therapy as salvage treatment for recurrent head and neck cancer

The infrahyoid flap: A comprehensive review of an often overlooked reconstructive method

Infrahyoid fascio‐myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction

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