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 modest‐sized 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.