“…Other studies correlate well with our findings and favor the oncologic safety of this flap. [23] Moreover, we have adopted the practice of lymph node dissection first before harvesting the flap. The surgeon should be prepared to experience any oncological surprise, such as finding positive lymph nodes at Level I, which could be either seen intraoperatively or proven by frozen sections.…”
Objectives:The submental flap provides an alternative technique in orofacial reconstruction, especially in situations where free flap services are not available. The objective of this study is to demonstrate the oncological safety and benefits of this flap in oral cavity reconstruction in a tertiary care cancer hospital.Materials and Methods:A total of 27 patients with oral cavity cancers, which underwent submental flap reconstruction from 2015 to 2017 at Shaukat Khanum Cancer Memorial Hospital, were included in the study. We have retrospectively reviewed records of these patients.Results:There were 25 male and 2 female patients with age ranging from 21 to 73 years. Most common primary tumor sites were buccal mucosa (13), tongue (7), and lower alveolus (7). All patients underwent ipsilateral selective neck dissection after flap was harvested. Complete flap loss was observed in three, whereas one patient had flap dehiscence that subsequently healed. Mean follow-up was 11 months. There were four regional recurrences but no local recurrence. On the last follow-up (minimum 6 months), 15 patients were alive without any disease, 4 were alive with disease, and 3 had died.Conclusion:Submental flap is a satisfactory option for oral cavity reconstruction. However, preoperative selection of clinically neck node-negative patient is extremely important as it has potential risk of occult metastasis.
“…Other studies correlate well with our findings and favor the oncologic safety of this flap. [23] Moreover, we have adopted the practice of lymph node dissection first before harvesting the flap. The surgeon should be prepared to experience any oncological surprise, such as finding positive lymph nodes at Level I, which could be either seen intraoperatively or proven by frozen sections.…”
Objectives:The submental flap provides an alternative technique in orofacial reconstruction, especially in situations where free flap services are not available. The objective of this study is to demonstrate the oncological safety and benefits of this flap in oral cavity reconstruction in a tertiary care cancer hospital.Materials and Methods:A total of 27 patients with oral cavity cancers, which underwent submental flap reconstruction from 2015 to 2017 at Shaukat Khanum Cancer Memorial Hospital, were included in the study. We have retrospectively reviewed records of these patients.Results:There were 25 male and 2 female patients with age ranging from 21 to 73 years. Most common primary tumor sites were buccal mucosa (13), tongue (7), and lower alveolus (7). All patients underwent ipsilateral selective neck dissection after flap was harvested. Complete flap loss was observed in three, whereas one patient had flap dehiscence that subsequently healed. Mean follow-up was 11 months. There were four regional recurrences but no local recurrence. On the last follow-up (minimum 6 months), 15 patients were alive without any disease, 4 were alive with disease, and 3 had died.Conclusion:Submental flap is a satisfactory option for oral cavity reconstruction. However, preoperative selection of clinically neck node-negative patient is extremely important as it has potential risk of occult metastasis.
“…The level Ia and bilateral level Ib cervical lymph nodes are identified and carefully dissected from the flap, while the submental vessels, facial vessels and marginal mandibular nerves are preserved (Figures 1–3). 7,8 Fig. 1.Submental island flap with vascular pedicle on the right side (white arrow).Fig.…”
Section: Methodsmentioning
confidence: 99%
“…4 However, not every patient is a suitable candidate for a microvascular procedure; therefore, pedicled flaps may have an important role in older patients or those with co-existing morbidities. 7 The submental island flap has been recognised as being a useful local flap for oral cavity reconstruction given its reliability, the low donor site morbidity and the short operative time. 7,8 This study aimed to compare the complications and functional outcomes in oral tongue cancer patients who underwent surgical resection followed by reconstruction with a submental island flap or a radial forearm free flap.…”
ObjectiveThis study compared the complications and functional outcomes of patients with oral tongue cancer who had undergone reconstruction using a submental island flap or a radial forearm free flap.MethodOf the 54 patients, 29 underwent reconstruction with a submental island flap and 25 patients with a radial forearm free flap. The complications and outcomes of speech and swallowing were evaluated.ResultsIn the submental island flap group, all the flaps were successfully transferred with no donor site complications. In the radial forearm free flap group, partial skin graft loss and arm function restriction were recorded. Mean operative time and duration of hospital stay were significantly shorter in the submental island flap group. Speech and swallowing function were comparable between the two groups. There was no significant difference in locoregional recurrence between the groups.ConclusionThe submental island flap is reliable and is suitable for oral tongue reconstruction. It has a lower complication incidence when compared to the radial forearm free flap, while maintaining speech and swallowing function.
“…However, the majority of those studies including our previous study have small sample sizes, and given the many factors that contribute to locoregional failure it is difficult for any of them, in our opinion, to cover and compare all these variables. [26][27][28][29][30] Tumor recurrence reported in literature, following oral cavity reconstruction using the SIF, ranges between 15.5% and 44.4%. 26,27 This wide range can be explained by the differences in sample size, patient selection, follow-up duration, and the variables looked at.…”
Background
Submental artery island flap (SIF) is a viable alternative to free flaps for selected oral‐cavity defects, however, concerns about its oncologic safety still exists. A novel harvesting technique and its outcome is described in here.
Methods
This is a prospective study for patients with lateralized oral tongue and/or floor of mouth (FOM) cancers who undergone reconstruction using pedicled SIF based on contralateral submental vessels (CSIF) following resection.
Results
Forty‐one patients were included. Twenty‐four patients had T2, 13 had T3, and 4 had T1 tumors. The largest flap skin paddle was 15 × 9 cm. One patient sustained complete and five sustained partial flap loss. Three patients developed tongue tethering. Median follow‐up was 13.6 months. Locoregional recurrence occurred in 11 patients (26.8%); 6 oral‐cavity recurrences (14.6%), 6 ipsilateral, and 1 contralateral neck recurrences (2.4%).
Conclusion
CSIF is a reliable flap that addresses the oncologic controversy and overcomes the disadvantages of ipsilateral flap.
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