European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 4, pp 1213–1217 | Cite as

The musculocutaneous infrahyoid flap: surgical key points

  • Haïtham Mirghani
  • Gustavo Meyer
  • Stéphane Hans
  • Gilles Dolivet
  • Sophie Périé
  • Daniel Brasnu
  • Jean Lacau St Guily
Head and Neck


For the first time in 1979, it was described by Wang that the infrahyoid musculocutaneous flap (IHMC flap) appears to be extremely suitable for medium-sized head and neck defect. Nevertheless, this flap remains unpopular because of its pretended lack of reliability. The aim of this study is to describe the surgical key points and to expose its main advantages. An IHMC flap was achieved on 32 patients to repair tissue loss due to surgical resection of a squamous cell carcinoma of the upper aero-digestive tract, from March 2006 to January 2010. Medical records of each of these patients were retrospectively analysed by the investigators including the detailed clinical, pathological and operative reports. No patient presented with total flap necrosis. However, we experienced four skin paddles necrosis. In two cases, the necrosis was total and in two cases partial. All donor sites were closed primarily without any tension. One patient showed a major dehiscence of the neck skin incision that required a pectoralis major flap. The IHMC flap is reliable and the harvesting technique is simple when the surgical key points are respected. Its advantages make it a convenient flap for medium-sized head and neck defect.


Infrahyoid flap Medium-sized defect Reliable 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Wang HS, Shen JW, Ma DB, Wang JD, Tian AL (1986) The infrahyoid myocutaneous flap for reconstruction after resection of head and neck cancer. Cancer 57:663–668PubMedCrossRefGoogle Scholar
  2. 2.
    Eliachar I, Marcovich A, Har Shai Y, Lindenbaum E (1984) Arterial blood supply of the infrahyoid muscles: an anatomical study. Head Neck Surg 7:8–14PubMedCrossRefGoogle Scholar
  3. 3.
    Rabson JA, Hurwitz DJ, Futrell JW (1985) The cutaneous blood supply of neck: relevance to incision planning and surgical reconstruction. Br J Plast Surg 38:208–219PubMedCrossRefGoogle Scholar
  4. 4.
    Verhulst J, Souza Leão R (2004) The infrahyoid musculocutaneous flap: experience of 153 cases in the reconstruction of the oropharynx and oral cavity after tumoral excision. Rev Laryngol Otol Rhinol (Bord) 125:49–53Google Scholar
  5. 5.
    Deganello A, Manciocco V, Dolivet G, Leemans CR, Spriano G (2007) Infrahyoid fascio-myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction. Head Neck 29:285–291PubMedCrossRefGoogle Scholar
  6. 6.
    Dolivet G, Gangloff P, Sarini J, Ton Van J, Garron X, Guillemin F, Lefebvre JL (2005) Modification of the infrahyoid musculo-cutaneous flap. Eur J Surg Oncol 31:294–298PubMedCrossRefGoogle Scholar
  7. 7.
    Lockhart R, Menard P, Chout P, Favre-Dauvergne E, Berard P, Bertrand JC (1998) Infrahyoid myocutaneous flap in reconstructive maxillofacial cancer and trauma surgery. Int J Oral Maxillofac Surg 27:40–44PubMedCrossRefGoogle Scholar
  8. 8.
    Zhao YF, Zhang WF, Zhao JH (2001) Reconstruction of intraoral defects after cancer surgery using cervical pedicle flaps. J Oral Maxillofac Surg 59:1142–1146PubMedCrossRefGoogle Scholar
  9. 9.
    Windfuhr JP, Remmert S (2006) Infrahyoid myofascial flap for tongue reconstruction. Eur Arch Otorhinolaryngol 263:1013–1022PubMedCrossRefGoogle Scholar
  10. 10.
    Rojananin S, Suphaphongs N, Ballantyne AJ (1991) The infrahyoid musculocutaneous flap in head and neck reconstruction. Am J Surg 162:400–403PubMedCrossRefGoogle Scholar
  11. 11.
    Minni A, Mascelli A, Suriano M (2010) The infrahyoid myocutaneous flap in intra-oral reconstruction as an alternative to free flaps. Acta Otolaryngol 130:733–738PubMedCrossRefGoogle Scholar
  12. 12.
    Magrin J, Kowalski LP, Santo GE, Waksmann G, DiPaula RA (1993) Infrahyoid myocutaneous flap in head and neck reconstruction. Head Neck 15:522–525PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Haïtham Mirghani
    • 1
  • Gustavo Meyer
    • 2
  • Stéphane Hans
    • 2
  • Gilles Dolivet
    • 3
  • Sophie Périé
    • 4
  • Daniel Brasnu
    • 2
  • Jean Lacau St Guily
    • 4
  1. 1.Department of Otolaryngology, Head and Neck SurgeryInstitut Gustave RoussyVillejuifFrance
  2. 2.Department of Otolaryngology, Head and Neck Surgery, Faculty of MedicineUniversity René Descartes Paris V, Hospital Georges Pompidou, Assistance Publique Hôpitaux de ParisParisFrance
  3. 3.Head and Neck Surgery Unit, Oncologic Surgery DepartmentCentre Alexis VautrinVandoeuvre les NancyFrance
  4. 4.Department of Otolaryngology, Head and Neck Surgery, Faculty of MedicineUniversity Pierre et Marie Curie Paris VI, Hospital Tenon, Assistance Publique Hôpitaux de ParisParisFrance

Personalised recommendations