Novel case examples of the submental island flap in pediatric head and neck reconstruction

Wiedermann, Joshua; Romero, Nahir; Shah, Rahul K.; Preciado, Diego; Cohn, Jason E.; Kieliszak, Christopher R.; Joshi, Arjun S.

doi:10.1016/j.ijporl.2017.03.026

Cited by 2 publications

(6 citation statements)

References 24 publications

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“…In a review in 2014, Rahpeyma et al described several variants based on 90 published studies [49]. Its use is rare in the pediatric population, the youngest being at the age of 6 weeks for closure of a skull base defect from resection of a teratoma [50, 51]. In 1993, Posnick et al reported the first free fibula flap in the reconstruction of pediatric mandibular defect [52].…”

Section: Discussionmentioning

confidence: 99%

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: A case report

Maby¹,

Guay²,

Thuot³

2019

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundInfantile myofibromatosis is the most common benign fibrous tumor in infants. Three different types have been reported in the literature. The most commonly affected areas are the head, the neck and the trunk. Our patient showed a very high level of mandibular destruction resistant to all mandibular sparing treatment strategies requiring segmental mandibulectomy and complex reconstruction.Case presentationWe describe a rare case of multicentric infantile myofibromatosis with mandibular bone destruction. The treatment required a succession of chemotherapy, a subtotal transoral resection and a hemi-mandibulectomy. The mandibular reconstruction was staged with initial bridging titanium plate with a submental flap, followed later by a fibula free flap.ConclusionMandibular involvement by myofibromatosis is rare, and the extend of bone destruction and reconstruction make this case unique. To our knowledge, this is the only reported case of fibula free flap mandibular reconstruction in a patient with infantile myofibromatosis , as well as one of the youngest reported submental island flaps for any pathology. We describe the clinical presentation and management, including relevant imaging, histopathology, medical and surgical treatment as well as a review of relevant literature.

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Section: Discussionmentioning

confidence: 99%

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: A case report

Maby¹,

Guay²,

Thuot³

2019

Journal of Otolaryngology - Head & Neck Surgery

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“…In a series of 11 patients undergoing SMAF reconstruction following oral cancer resection, donor site necrosis was reported only in 1 patient. The flap was still completely viable, and the defect was covered by a deltopectoral flap 6 . In another review of 40 patients undergoing SMAF reconstruction, beard hair direction change was noted in 5 patients.…”

Section: Complicationsmentioning

confidence: 96%

“…The flap was still completely viable, and the defect was covered by a deltopectoral flap. 6 In another review of 40 patients undergoing SMAF reconstruction, beard hair direction change was noted in 5 patients. Although not life-threatening and, in many cases, unnoticeable, men with beards should be made aware of this outcome possibility.…”

Section: Complicationsmentioning

confidence: 99%

“…The SMAF is more widely used in adult patients, but has been reported in pediatric patients as well, with much lower numbers. 6 Locationally, the SMAF may be useful in smaller-sized defect reconstructions of the lower face and anterior neck. Submental artery island flap candidates include patients with severe comorbidities or the presence of other contraindications for free flap surgery or men who require a hair-bearing flap.…”

Section: Patient Evaluation Selection Indications and Contraindicationsmentioning

confidence: 99%

“…The SMAF may also be used for repair of intraoral defects. The SMAF is more widely used in adult patients, but has been reported in pediatric patients as well, with much lower numbers 6 . Locationally, the SMAF may be useful in smaller-sized defect reconstructions of the lower face and anterior neck.…”

Section: Patient Evaluation Selection Indications and Contraindicationsmentioning

confidence: 99%

See 2 more Smart Citations

Comprehensive Review of the Submental Flap in Head and Neck and Facial Reconstruction: What Plastic Surgeons Need to Know

Jahromi

McClure

Horen

et al. 2021

Journal of Craniofacial Surgery

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Since its first introduction by Martin and colleagues (1993) and with further revisions by Sterne et al (1996), the submental artery flap (SMAF) has proven to be an effective, reliable, safe, and valuable option in head, neck, and facial reconstructive surgeries. The SMAF utilizes a long pedicle based on the submental artery, a branch of the facial artery, which provides good reach to the lower two-thirds of the face with excellent cosmetic outcomes. It also maintains a good skin color match for facial and cervical defects with a mostly hidden donor site scar (in the majority of cases the donor site can be primarily closed after raising the flap). Although the use of the SMAF is associated with high patient and surgeon satisfaction along with low rates of complications, disadvantages including flap thickness and the hair-bearing nature of the submental skin, which may be problematic for coverage of orofacial defects, especially in male patients. Although it has been almost 30 years since its introduction, and the SMAF has been successfully used in over 500 reported cases of pediatric and adult patients, a comprehensive review of the different aspects of the SMAF is lacking in the medical literature.

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Novel case examples of the submental island flap in pediatric head and neck reconstruction

Cited by 2 publications

References 24 publications

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: A case report

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: A case report

Comprehensive Review of the Submental Flap in Head and Neck and Facial Reconstruction: What Plastic Surgeons Need to Know

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