Discussion
In comparison with the other flaps for oral reconstruction, there are
only a limited number of original articles concerning the IHMCF. This
flap is fairly robust, predominantly hairless, and is adequate option
for modestāsized oral cavity defects. Raising IHMCF does not carry the
same risk of violating the principles of an oncologic dissection as may
can occur with the dissection required for a pedicled submental island
flap6.
Flap failure with the IHMCF is typically a result of venous
insufficiency. Many authors have modified surgical techniques to improve
the survival of the skin paddle1,2,5. The importance
of avoiding partial skin flap necrosis cannot be under estimated.
Postoperative salivary fistulas as a result wound dehiscence can result
in an increase in the length of hospital stay.
With our modified surgical techniques, the survival rate of IHMCF is
100%. None of patients in our series developed a salivary fistula. The
main disadvantage of our technique is the resultant shortening of the
flap arc rotation for the flap because of a wider vasculature pedicle.
With our technique, our flaps were able to easily reach the floor of
mouth and alveolar ridge defects, however reconstruction of the anterior
tongue at the tip can be challenging.