Anatomic Study of the Vasculature of the Submental Artery Flap

Abstract

The submental artery island flap is a versatile option in head and neck reconstruction. This flap may be used for the coverage of perioral, intraoral, and other facial defects, leaving a relatively acceptable donor-site scar. In this study, the submental region of 13 formalin-fixed cadavers was dissected bilaterally. Comprehensive anatomical information regarding the pedicle of the flap and its relationship with the important adjacent structures is provided. The mean values of the measurements of the facial and submental arteries were as follows: the facial artery was 2.7 mm in diameter at the origin, and it crossed the mandibular border 26.6 mm from the mandibular angle. The origin of the submental artery was 27.5 mm from the origin of the facial artery, 5.0 mm from the mandibular border, and 23.8 mm from the mandibular angle. The diameter of the submental artery was 1.7 mm at the origin. The artery was found mostly to course superficial to the submandibular gland. In one case, the artery passed through the gland. The total length of the submental artery was 58.9 mm. The artery anastomosed with the contralateral artery in 92 percent of the cadavers. The submental artery was deep to the anterior belly of the digastric muscle in 81 percent of the cases. This study presents detailed anatomical data about the location, dimension, and relationship of the facial artery, the submental artery, and the submental vein that may be useful during dissection of the submental artery island flap.

The submental island flap in head and neck reconstruction

“…It runs medially on the mylohyoid muscle below the mandibular border, giving off 1-4 cutaneous perforators that pierce the overlying platysma muscle before forming a subdermal plexus that anastomoses extensively with the contralateral branches 11 . The submental artery ends behind the mandibular symphysis, just lateral to the midline, on the anterior belly of the digastric muscle 9 , from where it sends branches to the lower lip and sublingual gland 8 . The flap is drained through the submental vein into the facial vein.…”

Bipaddled submental artery flap

“…3,10 To the best of the authors' knowledge, a bipaddled variant of this flap has not been described previously. To conclude, the bipaddled submental artery flap may be a useful modification of the standard flap in the reconstruction of full thickness cheek defects following resection for oral cancer (Fig.…”

Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review

“…The premasseteric artery (PMA) ramifies from the FA and it ascends upward along the anterior border of the MST, after its emergence on the face [40]. The PMA gives off branches (MbPMA) to the anterior portion of the MST, especially its superficial layer [64].…”