Oncological aspects of the use of infrahyoid myocutaneous flap in the treatment of oral cancer

Objective. Analysis of the use of infrahyoid myocutaneous flap (IHF) to eliminate postoperative defects in patients with stage III—IV oral cancer. Material and methods. According to the inclusion criteria 73 patients formed Group 1. Group 2 (control group) consisted of 43 patients in whom primary closure was used for the reconstruction. Most patients in Group 1 and 2 had pT3-4 primaries (63% and 69%) and pN+ stage (67% and 71%). Case files were analyzed for the incidence of complications, duration of nasogastric tube feeding and number of patients who received adjuvant radiation. Oncologic effectiveness was assessed by the rate of locoregional recurrence, distant metastasis and overall survival. Results. The higher incidence of complications in Group 1 (37% vs 10% in Group 2, p=0.001) was associated with the high rate of partial flap necrosis (18 cases, 25%). Difference in the rate of operating room return (8% vs 7%) and salivary fistula (1% vs 2%) in Group 1 and 2 was statistically insignificant. The mean duration of nasogastric tube feeding was 12.9 and 11.8 days. Less proportion of patients in Group 1 (66% vs 83%, p=0.053) underwent adjuvant radiation. The rate of local, regional recurrence and distant metastases in Group 1 and 2 were 22% and 12%, 19% and 7%, 12% and 12% without statistical significance between groups. The rate of regional recurrence on the side of neck dissection was equal: 8% and 7%. Overall 5-year survival was 42.9% and 47.7%, respectively (p=0.144). Conclusion. The IHF use for oral cavity ablative defects is not associated with deterioration of oncologic results.