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

Philip, Jerome; Mizen, Kelvin; Singh, Mark; Karzai, Laszlo; Saunders, Kat; Bazira, Peter J.

doi:10.1016/j.bjoms.2023.01.008

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…However, the lymph node metastasis in level I made it controversial to employ facial-artery-based regional flaps in oncologic defect reconstruction (18,19). Strict limitation to the cN 0 patients and pedicle skeletonization were suggested in previous studies (18,20,22,23), but occult metastasis was still present in 34%-45% of cN 0 necks (19, 24,25), and 25% of the skeletonized flap pedicles were histologically confirmed to contain lymph nodes (26). To overcome this difficulty, contralateral facial-artery-based nasolabial flap and submental island flap were introduced in recent years (27,28).…”

Section: Discussionmentioning

confidence: 99%

Contralateral facial artery myomucosal island flap for the reconstruction of T2-T3 oncologic oral defects

Huang,

Li,

Yang

et al. 2024

Front. Oncol.

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ObjectivesTo avoid the oncologic risks of ipsilateral regional flaps, this study aimed to explore the feasibility and clinical outcomes of the contralateral-based facial artery myomucosal island flap (C-FAMMIF) for oral T2–T3 oncologic defects reconstruction.MethodsA study of flap anatomy was conducted on 7 cadaver samples and a cohort of 24 patients who received C-FAMMIF reconstruction after malignancy resection were retrospectively researched. A balanced anterolateral thigh flap (ALT) group of 47 patients was extracted as control group using propensity score matching method. Progression-free survival (PFS), functional outcomes, and donor site complications were assessed.ResultsConsistent blood supply and drainage through facial artery and vein with median maximum pedicle length of 106 mm supported contralateral reconstruction. The superficial vein drainage pattern indicated safer flap harvest at contralateral neck under circumstances of ipsilateral neck dissections. The pedicle and marginal facial nerve formed three anatomical patterns. The surgical management of each was described. Patients with ipsilateral pN+ neck accounted for 41.7% and 40.4% in the C-FAMMIF and ALT group, respectively. The 2-year PFS rate between the C-FAMMIF and ALT groups was not significantly different (88.2% in C-FAMMIF group and 84.6% in ALT group, respectively, p = 0.6358). Promising recoveries were observed for swallowing function and tactile sensation. The donor sites healed upon primary closure without trismus or permanent facial palsy.ConclusionOur findings suggested that C-FAMMIF is feasible and safe for T2-T3 oral oncologic defect reconstruction in patients with ipsilateral cN+ neck.

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Section: Discussionmentioning

confidence: 99%

Contralateral facial artery myomucosal island flap for the reconstruction of T2-T3 oncologic oral defects

Huang,

Li,

Yang

et al. 2024

Front. Oncol.

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An Innovative Methodology: The Submental Island Flap Offers Enhanced Soft Tissue Coverage to the Vascularized Iliac Crest Flap

Dou,

Yu,

Jia

et al. 2024

Journal of Craniofacial Surgery

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The vascularized iliac crest flap has garnered widespread acclaim within the field of mandibular reconstruction attributable to its sufficient bone mass and congruent curved morphology. However, when the precise orientation of the iliac crest is imperative during mandibular reconstruction and there exists an accompanying defect within the oral soft tissue, the indispensability of an additional flap to facilitate concurrent defect repair becomes evident. In such instances, the submental island flap emerges as an exemplary candidate.

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

Cited by 3 publications

References 29 publications

Contralateral facial artery myomucosal island flap for the reconstruction of T2-T3 oncologic oral defects

Contralateral facial artery myomucosal island flap for the reconstruction of T2-T3 oncologic oral defects

An Innovative Methodology: The Submental Island Flap Offers Enhanced Soft Tissue Coverage to the Vascularized Iliac Crest Flap

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