Oncologic safety of submental island flap reconstruction in clinically node-negative oral cancer patients: a prospective comparative study

Mishra, Aseem; Mishra, Niranjan; Pati, Dakshya Prasad; Samal, Dillip Kumar; Kar, Indu Bhusan; Mohapatra, Debahuti; Sarkar, Dibya Falgoon

doi:10.1016/j.ijom.2021.05.010

Cited by 10 publications

(12 citation statements)

References 22 publications

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“…Although there is inadequate long-term follow up from these presented cases to comment on the potential long-term oncologic impact of the submental island flap in these particular cases, the oncologic safety of the submental island flap has now been well studied and established in numerous studies. 2,3,8,[10][11][12][13][14][15] The results of this small series of cases will need to be corroborated by studies confirming the reliability of this technique with a larger number of cases. Regardless, this small series documents the excellent viability of the submental island flap in the context of prior contralateral neck dissection thus far witnessed in our practice.…”

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…1-7 Relative to free tissue transfer, the submental island flap is associated with decreased operative time, postoperative length of stay, and overall hospital cost, with similar functional and oncologic outcomes. 2,3,8-15…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Relative to free tissue transfer, the submental island flap is associated with decreased operative time, postoperative length of stay, and overall hospital cost, with similar functional and oncologic outcomes. 2,3,[8][9][10][11][12][13][14][15] Occasionally the situation arises when the reconstructive head and neck surgeon may contemplate using a submental flap when a prior contralateral neck dissection has previously been performed. The question that necessarily arises is whether the flap vascular integrity would be compromised either by the prior underlying dissection or by inclusion of the remote neck incision scar within the flap skin paddle.…”

Section: Introductionmentioning

confidence: 99%

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Submental Island Flap After Prior Contralateral Neck Dissection: A Case Series and Technical Considerations

Larson

Abt

Deschler

2021

Ann Otol Rhinol Laryngol

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Objectives: The submental island flap is a dependable workhorse in head and neck reconstruction. However, the viability of this flap has not been established for oral cavity reconstruction when a contralateral neck dissection has already been performed in an earlier surgical setting. The aim of this study is to highlight technical considerations and outcomes of this approach with a small case series. Methods: Three cases of oral cavity reconstruction with a submental island flap elevated in the context of a prior contralateral neck dissection are presented. Results: In all cases, a doppler was used to identify the maintenance of the submental perforator in the neck opposite the previous neck dissection. In 2 cases, level IA was included within the dissection field of the previous neck dissection. Additionally, the old neck scar was included within the skin paddle of the submental island flap in 2 cases. In all cases, excellent healing of the flap was observed without partial or complete loss. Conclusions: The submental island flap appears to be a reliable reconstruction when a previous contralateral neck dissection has been performed, even when level IA was included in the prior dissection.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Submental Island Flap After Prior Contralateral Neck Dissection: A Case Series and Technical Considerations

Larson

Abt

Deschler

2021

Ann Otol Rhinol Laryngol

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“…The submental artery flap (SMAF) is a regional flap, which was firstly described in 1993 [ 6 ], was globally developed as a useful flap for medium-sized surgical defects for HNSCC from retrospective and prospective studies [ 7 , 8 ]. The SMAF with both less invasive procedures and good oncologic results was evaluated as a game-changer reconstruction without microvascular anastomosis in comparison to free-flap reconstruction [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Lymph Node Ratio in Head and Neck Cancer with Submental Flap Reconstruction

et al. 2022

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This study aimed to investigate the relationship between the lymph node ratio (LNR) and survival results of patients with head and neck squamous cell carcinoma (HNSCC) reconstructed by a submental artery flap (SMAF) to limit tumor size. This study retrospectively recruited 49 patients with HNSCC who underwent both primary resection and neck dissection with SMAF reconstruction. The LNR was the ratio of the number of metastatic lymph nodes to the sum number of examined lymph nodes. A LNR of 0.04 was the best cut-off value for HNSCC-specific death on receiver operating curve analysis. Patients with LNRs > 0.04 were univariately related to cancer-specific, disease-free, distant metastasis-free, and locoregional recurrence-free survival than those with LNRs ≤ 0.04 by log-rank test. In a Cox’s proportional hazards model with hazard ratio (HR) and 95% confidence interval (CI) adjusting for pathological stage, extranodal extension and or surgical margins, the LNR (>0.04/≤0.04) predicted multivariate shorter cancer-specific (HR = 9.24, 95% CI = 1.49–176), disease-free (HR = 3.44, 95% CI = 1.23–10.3), and distant metastasis-free (HR = 9.76, 95% CI = 1.57–187) survival. In conclusion, LNR for patients of HNSCC with SMAF reconstruction for limited tumor size was a prognostic factor for survival outcomes.

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Submental island flap - should we be worried about lymph node transfer? An anatomical and histological study

Philip¹,

Mizen

Singh³

et al. 2023

British Journal of Oral and Maxillofacial Surgery

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Oncologic safety of submental island flap reconstruction in clinically node-negative oral cancer patients: a prospective comparative study

Cited by 10 publications

References 22 publications

Submental Island Flap After Prior Contralateral Neck Dissection: A Case Series and Technical Considerations

Submental Island Flap After Prior Contralateral Neck Dissection: A Case Series and Technical Considerations

Lymph Node Ratio in Head and Neck Cancer with Submental Flap Reconstruction

Submental island flap - should we be worried about lymph node transfer? An anatomical and histological study

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