Versatility of the submental island flap in head and reconstruction

Abstract

<p class="abstract"><strong>Background:</strong> Head neck cancer is major cause of morbidity and mortality worldwide. India has one of the highest incidences of oral cancer and accounts for about 30% of all new cases annually. Ablative surgery is main stay of treatment which is followed by reconstructive surgery. Microvascular surgery revolutionized onco-reconstruction which requires great expertise even in tertiary cancer centre and it is not possible many times due to long waiting list for it or patient condition. Here there is role locoregional pedicled flap which mitigate this problem to great extent to achieve acceptable functional and aesthetic outcome. One such flap worth to keep in surgeon armamentarium is submental island flap. Submental artery island flap (SIF) is an axial fasciocutaneous flap that includes skin, subcutaneous tissue, platysma, and fat and is pedicled on the submental artery and veins.</p><p class="abstract"><strong>Methods:</strong> This study conducted in our institute a tertiary level cancer hospital. This is retrospective study. Data extracted from department database between periods February 2015 to May 2017. It includes 12 patients diagnosed with different sub site oral cancer, operated in department of head neck oncology for oral cancer and reconstruction fallowing ablative surgery done by submental island flap by ablative surgeon. </p><p class="abstract"><strong>Results:</strong> Submental island flaps are comparable in their outcome with radial forearm free flap. They carry a good color match with facial tissue. It is thin and has a reliable vascular morphology.</p><strong>Conclusions:</strong> When combined with the reported experience of other surgeons, our preliminary experience shows that the SIF is an excellent alternative in the reconstruction of head and neck defects because of its reliability, versatility, and relative ease of application. Neck dissection can plan as an adjunctive procedure to the SIF with certain limitation.

Modified submental platysmal adipomyofascial flap: is it a reliable alternate reconstructive option for small- to mid-sized defects especially in male patients with oral/oropharyngeal cancer?

“…Post-operative adjuvant RT negates this problem to some extent. Katre et al [10] reported their previous experience with submental flap, in which they experienced similar issue of hair-bearing skin in oral cavity in males, who did not receive adjuvant RT. These patients then had to undergo a second procedure of skin de-epithelialization or laser epilation at a later stage which further adds to the cost incurred by the patients.…”

“…The submental flap has a long and reliable vascular pedicle, which provides a pedicle length up to 8 cm, with an average of 2-mm arterial diameter. Although the largest skin paddle used was 14 × 7 cm according to the English literature, it has been proposed that a skin paddle up to 18 × 7 cm is possible, depending on the laxity of the submental skin [10].…”