Modified Infrahyoid Myocutaneous Flap: A Systematic Review of Surgical Techniques

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A systematic review published in Cureus on July 24, 2026, examines modifications to the infrahyoid myocutaneous flap technique, a surgical approach used in head and neck reconstruction. The study, conducted by a team of otolaryngologists and plastic surgeons, analyzes the evolution of this procedure over the past decade, focusing on refinements that aim to improve patient outcomes and reduce complications.

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Surgical Technique and Purpose
The infrahyoid myocutaneous flap involves harvesting tissue from the neck to reconstruct defects in the head and neck region, often following tumor removal or trauma. The modified technique, as detailed in the review, incorporates adjustments to flap design, vascular management, and postoperative care. These changes are intended to address limitations of the traditional method, such as tissue necrosis, delayed healing, and donor-site morbidity.

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According to the review, the modified approach has been adopted in 23 clinical studies spanning 12 countries, with data from over 400 patients. Key modifications include the use of Doppler ultrasound to assess blood flow during flap creation and the implementation of a two-stage reconstruction process to minimize tension on the graft. The authors note that these adjustments have led to a 15% reduction in flap failure rates compared to historical data from the pre-modification era.

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Clinical Outcomes and Comparative Analysis
The study evaluates outcomes across multiple centers, highlighting improvements in functional and aesthetic results. Patients who underwent the modified procedure reported better swallowing function and fewer visible scars than those who received the traditional flap. Additionally, the review identifies a 20% decrease in hospital readmissions within the first month post-surgery.

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While the findings suggest promise, the authors caution that the evidence remains limited by small sample sizes and varying surgical protocols. “Most studies are single-center and lack long-term follow-up,” the review states. “Larger, randomized trials are needed to confirm these results.”

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Implications for Surgical Practice
The review emphasizes the importance of standardized training for surgeons adopting the modified technique. It recommends incorporating the use of advanced imaging and real-time monitoring tools to enhance precision. Institutions in the U.S., Europe, and Asia have begun integrating these guidelines into their residency programs, according to the study.

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Dr. Emily Torres, a lead author of the review and a reconstructive surgeon at Memorial Health System, noted that the modifications “represent a significant step forward for patients requiring complex head and neck reconstructions.” She added, “However, surgeons must balance innovation with caution, ensuring that new methods are thoroughly validated before widespread adoption.”

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Challenges and Future Directions
The review highlights challenges in adopting the modified technique, including the need for specialized equipment and extended surgical times. It also points to disparities in access to these advancements, with resource-limited regions facing barriers to implementation.

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The authors call for global collaboration to address these gaps, suggesting partnerships between high-income and low-income countries to share expertise and resources. They also advocate for the development of cost-effective alternatives to the modified flap, which could expand access to this treatment.

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Conclusion
The systematic review underscores the potential of the modified infrahyoid myocutaneous flap to improve outcomes in head and neck surgery, while acknowledging the need for further research. As the field continues to evolve, the study provides a framework for evaluating new surgical techniques through rigorous, evidence-based analysis.

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Cureus, a peer-reviewed open-access journal, published the review after undergoing standard academic scrutiny. The study was supported by grants from the National Institute of Dental and Craniofacial Research and the European Society of Head and Neck Surgery.

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“Surgeons must balance innovation with caution, ensuring that new methods are thoroughly validated before widespread adoption.”
SourceDr. Emily Torres, lead author of the review