Reconstruction with submental flap for aggressive orofacial cancer- an updated series

Chow, Tam‐Lin; Kwan, Wilson W.Y.; Fung, Siu‐Chung; Ho, Lai-In; Au, K H

doi:10.1016/j.amjoto.2018.07.014

Cited by 12 publications

(16 citation statements)

References 22 publications

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“…Revision cases and irradiated necks were excluded from the study anticipating a compromised vascular pedicle, although successful reconstruction of the submental island flap in the irradiated neck has been described in the irradiated neck which is also a relative contraindication for free flaps reconstruction 9, 10. Submental island flap is found to be associated with low mortality and morbidity as was evident in our study till 6 months of follow-up, also described in the past literature 8, 11, 12, 13. Hair growth in the oral cavity can be a problem in the postoperative period, as mucosalization occurs with the course of time in the majority of the patients or else radiotherapy itself causes burning of the hair follicles.…”

Section: Discussionsupporting

confidence: 80%

Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases

Pradhan

Samal

et al. 2019

World j. otorhinolaryngol.-head neck surg.

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Objective The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site, fewer donor site morbidity and the cost effectiveness of the procedure. Methods A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital. Patients with clinical staging I/II/III (T1/T2/T3, N0) oral malignancy were included in the study. Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study. Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient. Patients were followed at monthly interval till 6 months in the postoperative period. Results The buccal mucosa (12 patients), tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity. Partial and complete skin necrosis was found in 4 and 2 patients respectively. Postoperative chemoradiation was required in 5 patients. None of the patients had loco regional recurrence till 6 months of follow-up. Conclusion The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle, less donor site morbidity and the lower cost compared to the free flaps, often preferred in patients with a lower socioeconomic condition.

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Section: Discussionsupporting

confidence: 80%

Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases

Pradhan

Samal

et al. 2019

World j. otorhinolaryngol.-head neck surg.

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“…Reconstruction of oral cavity defects following radical surgery for SCC can be achieved by a variety of techniques [1][2][3][4][5][6] . The choice is influenced by several factors, including size and location of the defect, patient characteristics, donor site morbidity, and functional and aesthetic outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13] . Nowadays microvascular free flaps, for instance anterolateral tight (ALTFF) and radial forearm (RFFF), are considered the gold standard among head and neck surgeons for restoration of oral defects.…”

Section: Introductionmentioning

confidence: 99%

“…Nowadays microvascular free flaps, for instance anterolateral tight (ALTFF) and radial forearm (RFFF), are considered the gold standard among head and neck surgeons for restoration of oral defects. However, in some particular situations, as in compromised patient in which a time-consuming procedure is at high risk, a pedicled flap could be a better choice [9][10][11][12][13] . Moreover, in small defects the donor site morbidity and aesthetic outcomes have to be taken into account 2,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in small defects the donor site morbidity and aesthetic outcomes have to be taken into account 2,4 . Many loco-regional pedicle flaps are available for head and neck reconstruction [9][10][11][12][13][14][15] ; among these, the MPF presents some advantages, for instance appropriate thickness, ideal pliability, wide arch of rotation (almost 180°), and good colour match with facial skin in case of external reconstruction. Furthermore, donor site morbidity is low, and it is easy to access in the same operative field, reducing the operation time [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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Platysma myocutaneous flap revised in the free flaps era: clinical experience in 61 patients

Calabrese

Accorona

Gazzini³

et al. 2020

Acta Otorhinolaryngol Ital

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“…The submental island flap (SIF) is an excellent option for reconstructing a variety of defects that extend beyond the lower facial region. Several studies have outlined practical advantages of the SIF, including safe dissection by residents in-training, enhanced outcomes when compared to radial forearm free flaps for similar defects, and excellent cosmetic results at both defect and donor sites [1,3,[9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit

Khan

Haupt

Rigby

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background The submental island flap (SIF) is a reliable option for reconstructing defects in the facial region and offers several advantages when compared to free-flap alternatives. While the reconstructive applications of the SIF have been demonstrated in the lower face, there are limited reports on its utility as a composite flap for reconstructing defects of the upper facial skeleton. To our knowledge, we report the first cases of composite (osteocutaneous) SIFs used for reconstruction of complex facial defects involving the zygoma and lateral orbit respectively. Case presentations Three consecutive cases are presented. All were performed following resection of skin cancers with invasion of the upper facial skeleton. The first case was a 68-year-old male with a longstanding history of non-melanoma skin cancers who presented with a 7 cm recurrent basal cell carcinoma (BCC) with bicortical invasion of the left zygoma. The second case was an 88-year-old female with several squamous cell carcinomas (SCC), including a dominant 7.1 cm SCC on the right temple with orbital invasion. A third case was a 75-year-old immunosuppressed male with a 6.5 cm SCC of the right cheek with invasion of the orbit and zygoma following prior resection as well as high dose radiotherapy. The operative management of all cases involved harvesting the SIF on its vascular pedicle alongside the inferior portion of the mandible with rigid fixation to address the bony defects. The first case was robust throughout adjuvant radiotherapy with no flap complications after 2 year follow up. The second patient received adjuvant radiation therapy to an area that was previously radiated. Although the flap remained viable for a year, the patient experienced delayed soft tissue loss over the bony segment and eventual devitalization of the distal flap. The third case achieved a satisfactory result with no complications. Conclusions Our case series outlines a unique application of the composite (osteocutaneous) submental island flap (SIF) for reconstruction of complex facial defects involving the upper facial skeleton. The osteocutaneous SIF should be used with caution in patients receiving adjuvant radiotherapy who have a history of previous radiation to the same or overlapping field. Graphical abstract

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Reconstruction with submental flap for aggressive orofacial cancer- an updated series

Cited by 12 publications

References 22 publications

Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases

Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases

Platysma myocutaneous flap revised in the free flaps era: clinical experience in 61 patients

Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit

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