The submental island flap: Pedicle elongation and indications in head and neck reconstruction

Ferrari, Silvano; Copelli, Chiara; Bianchi, Bernardo; Magri, Alice Sara; Ferri, Andrea; Varazzani, Andrea; Poli, Tito; Ferri, Teore; Sesenna, Enrico

doi:10.1016/j.jcms.2014.01.025

Cited by 18 publications

(14 citation statements)

References 22 publications

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“…We consider it as an important advantage of the SMI-flap to other local flaps of the skin of the anterior neck (such as platysma flaps and supraclavicular flaps) that the SMI-flap provides an appropriate mobility to treat all regions of the oral cavity [18]. The mobility of the entire flap can be increased further by elongation of the vascular pedicle when the facial artery and vein are divided above or below of the origin of the submental vessels [19][20][21]. However, for the intraoral application of the SMI-flap in our study this was not essential and therefore not performed.…”

Section: Recurrence-free Survivalmentioning

confidence: 99%

The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates

et al. 2015

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Section: Recurrence-free Survivalmentioning

confidence: 99%

The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates

et al. 2015

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“…A summary of the clinical applications of SFs in the literature indicates that the recipient sites include the cheek, lower lip, orbit, forehead, auricular, temporal, parotid, mouth floor, alveolus, cervical esophagus, glottis, tongue, preauricular, maxilla, ear canal, mentum, larynx, retromolar trigone, hard palate, infraorbital, jaw, parotid, mastoid, parapharyngeal space and lateral skull base (Magden et al, 2004; Martin et al, 1993; Pinar, Govsa & Bilge, 2005; Pistre et al, 2001; D’Silva, Pulakunta & Potu, 2008; Gupta et al, 2003; Patel, Bayles & Hayden, 2007; Ferrari et al, 2014; Demir, Velidedeoglu & Çelebioglu, 2005; Tan, Atik & Parmaksizoglu, 2007; Abouchadi et al, 2007; Hayden, Nagel & Donald, 2014; Howard et al, 2016; Liu et al, 2013; Taghinia et al, 2009; Tassinari et al, 2010; Vural & Suen, 2000; Lee et al, 2013a; Lee et al, 2013b; Howard et al, 2014; Husso et al, 2015). …”

Section: Discussionmentioning

confidence: 99%

Vascular anatomy is a determining factor of successful submental flap raising: a retrospective study of 70 clinical cases

Lin

Huang

Chu

et al. 2017

PeerJ

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The vascular anatomy of submental flaps (SFs) represents a determining factor in successful SF raising. However, little attention has been focused on the venous return of SFs. Thus, the present study aimed to investigate SF venous return. This study enrolled patients who underwent SF reconstructive surgery in a tertiary referral center between November 2009 and October 2016. The drainage pathway of the SF venous return was routinely identified during the course of our operations to prevent damage during head and neck surgery. The venous return data of 70 patients were reviewed. The size of the flaps ranged from 15 to 84 cm2, and total flap loss was not observed in the case series. All of the submental arteries originated from the facial artery; however, the submental veins of 70 patients returned to either the internal jugular vein (IJV, 72.9%) or the external jugular vein (EJV, 27.1%). Our data suggest that drainage of the submental vein into the EJV, which has been previously overlooked, should receive greater attention during SF surgeries. The results support mandatory preservation of the EJV and IJV and indicate that vascular anatomy is a determining factor for successful SF raising.

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“…We have reported only one case of temporary mandibular neuropraxia, resolving within 3-months. However, in the retrograde variation, the risk of nerve injury appears to increase, especially when increased arc of rotation is required 23 .…”

Section: A C C E P T E D Complicationsmentioning

confidence: 99%

Twenty-Five Years of Experience with the Submental Flap in Facial Reconstruction: Evolution and Technical Refinements following 311 Cases in Europe and Africa

Bertrand

Honeyman

Emparanza

et al. 2019

Plastic &Amp; Reconstructive Surgery

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Background: The submental flap is a pedicled island flap with excellent colour match for facial reconstruction. The flap can be raised with muscle, submandibular gland or bone and can be transposed to reach defects up to two thirds of the face. We report the primary author's experience of 25 years using the submental flap from its original description to most recent technical evolutions in both Europe and Africa. Methods: This is a retrospective study including all patients with facial defects reconstructed using a submental flap between 1991 and 2016. This study included the use of all four variations of the submental flap: "platysmal', "digastric", "extended" and "super extended". We report technical adaptations and complications encountered. Results: We performed 311 facial reconstructions using submental flaps: 32 "platysmal", 133 "digastric", 91 "extended" and 45 "super extended" variations. In conjunction with these reconstructions, we performed 10 osteocutanous submental flaps and 2 free flaps. We report 2 cases of total flap necrosis (0.6%) and 28 minor complications including: 23 cases of distal skin necrosis (7%), 1 reversible mandibular facial nerve palsy (0.3%) and 3 hematomas (1%). Conclusions: The submental flap has proven to be a reliable flap for head and neck reconstruction. The four technical modifications described employ varying amounts of soft tissue to replace tissue lost and can include vascularized bone from the mandibular margin. This flap exemplifies Gillies' principle of "replacing like with like" and should be discussed as an alternative to free tissue transfer in facial reconstruction, especially in settings where resources are limited.

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The submental island flap: Pedicle elongation and indications in head and neck reconstruction

Cited by 18 publications

References 22 publications

The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates

The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates

Vascular anatomy is a determining factor of successful submental flap raising: a retrospective study of 70 clinical cases

Twenty-Five Years of Experience with the Submental Flap in Facial Reconstruction: Evolution and Technical Refinements following 311 Cases in Europe and Africa

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