New approach to an overlooked flap: Technique to augment venous drainage of the infrahyoid myocutaneous flap.

Background: To describe a technique in which the anterior jugular vein is preserved in the infrahyoid myocutaneous flap (IHMCF) to augment skin paddle venous drainage.

Methods: From April 2018 to December 2019, 14 patients with primary oral cancer underwent radical resection and IHMCF reconstruction. Three-dimensional reconstruction of the anterior jugular vein was used to assess the venous drainage of the skin paddle preoperatively. The anterior jugular vein was preserved during dissection of the flap. Healing of the recipient and donor sites was observed.

Results: Total flap necrosis occurred in one patient and marginal skin paddle necrosis occurred in one patient. No flap complications occurred in the other 12 patients.

Conclusion: This new approach to augment venous drainage of the IHMCF appears to be effective for decreasing risk of flap necrosis.