Submental Osteocutaneous Perforator Flap for Maxillary and Mandibular Reconstruction Following Tumor Resection

Marcos, Jose A. García-de; Arroyo-Rodrı́guez, Susana; Rey‐Biel, J

doi:10.1016/j.joms.2015.11.018

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…Pedicled flaps previously described include the submental, temporalis, temporoparietal fascia, and pectoralis flaps. [9][10][11][12][13][14][15] These can be excellent options in situations of limited volume defects and in patients who have the body dimensions allowing adequate reach of these flaps. However, disadvantages of these flaps include the typically limited pedicle length placing the flap on tension or not even being able to reach the defect as well as the inability to fill the defect volume.…”

Section: Discussionmentioning

confidence: 99%

Custom Presurgical Planning for Midfacial Reconstruction

et al. 2020

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Resection and reconstruction of midface involve complex ablative and reconstructive tools in head and oncology and maxillofacial prosthodontics. This region is extraordinarily important for long-term aesthetic and functional performance. From a reconstructive standpoint, this region has always been known to present challenges to a reconstructive surgeon due to the complex three-dimensional anatomy, the variable defects created, combination of the medical and dental functionalities, and the distance from reliable donor vessels for free tissue transfer. Another challenge one faces is the unique features of each individual resection defect as well as individual patient factors making each preoperative planning session and reconstruction unique. Understanding the long-term effects on speech, swallowing, and vision, one should routinely utilize a multidisciplinary approach to resection and reconstruction, including head and neck reconstructive surgeons, prosthodontists, speech language pathologists, oculoplastic surgeons, dentists, and/or craniofacial teams as indicated and with each practice pattern. With this in mind, we present our planning and reconstructive algorithm in midface reconstruction, including a dedicated focus on dental rehabilitation via custom presurgical planning.

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Section: Discussionmentioning

confidence: 99%

Custom Presurgical Planning for Midfacial Reconstruction

et al. 2020

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“…13 Unique variations of this flap have been described, such as incorporating a segment of the basal bone of the inferior border of the mandible in the symphyseal region resulting in an osteocutaneous flap with the osseous component receiving its blood supply from periosteal perforators. 14 The SIF has also been described as having the potential of being raised in a fashion that allow for elevating bilateral submental flaps by dividing the skin paddle obliquely in a fashion that preserves each submental artery. 13 This modification has been previously reported by Patel and colleagues.…”

Section: Discussionmentioning

confidence: 99%

Submental Artery Island Flap for Soft Tissue Coverage of a Mandibular Reconstruction Plate in a High-Risk Patient With Medication-Related Osteonecrosis of the Jaw

Shanti

Choi²,

Okasha³

et al. 2020

Craniomaxillofacial Trauma & Reconstruction Open

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We present a case of a 69-year-old woman with multiple complicating comorbidities who developed medication-related osteonecrosis of the jaw secondary to extraction of multiple teeth with a history of intravenous bisphosphonate therapy for metastatic breast cancer requiring staged management with segmental mandibulectomy with placement of external pin fixator with subsequent exchange of this device for a titanium reconstruction plate and a submental island pedicled flap for soft tissue coverage of the bridging reconstruction plate. Once the surgical sites were well-healed that patient would immediately return to a satisfactory functional outcome with ability to tolerate a soft diet. Furthermore, the patient did not have complications (ie, cardiac, pulmonary, venous thromboembolism, sepsis, surgical site infection, reoperation) during her hospitalization and has done well with her long-term recovery.

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“…We described the osteocutaneous version of the submental flap in our original description 6 in 1993. Bony blood supply to the mandible is ensured by direct and muscular branches coming from the submental pedicle 7,10 . We performed the first case of "platysmal" osteocutaneous submental flap in 1996 to reconstruct the zygomatic arch (case 1).…”

Section: Flap Variations According To the Nature Of The Defectmentioning

confidence: 99%

“…Utilizing the technique of YV lengthening of the pedicle or the retrograde harvest of the facial artery allows reconstruction of defects up to two thirds of the face without the need for microsurgery [3][4][5] . Multiple submental flap variants have now been described and include the harvesting of skin, muscle, submandibular gland and or bone to allow the flap to conform to the majority of complex composite facial defects 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Twenty-Five Years of Experience with the Submental Flap in Facial Reconstruction: Evolution and Technical Refinements following 311 Cases in Europe and Africa

Bertrand

Honeyman

Emparanza

et al. 2019

Plastic &Amp; Reconstructive Surgery

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Background: The submental flap is a pedicled island flap with excellent colour match for facial reconstruction. The flap can be raised with muscle, submandibular gland or bone and can be transposed to reach defects up to two thirds of the face. We report the primary author's experience of 25 years using the submental flap from its original description to most recent technical evolutions in both Europe and Africa. Methods: This is a retrospective study including all patients with facial defects reconstructed using a submental flap between 1991 and 2016. This study included the use of all four variations of the submental flap: "platysmal', "digastric", "extended" and "super extended". We report technical adaptations and complications encountered. Results: We performed 311 facial reconstructions using submental flaps: 32 "platysmal", 133 "digastric", 91 "extended" and 45 "super extended" variations. In conjunction with these reconstructions, we performed 10 osteocutanous submental flaps and 2 free flaps. We report 2 cases of total flap necrosis (0.6%) and 28 minor complications including: 23 cases of distal skin necrosis (7%), 1 reversible mandibular facial nerve palsy (0.3%) and 3 hematomas (1%). Conclusions: The submental flap has proven to be a reliable flap for head and neck reconstruction. The four technical modifications described employ varying amounts of soft tissue to replace tissue lost and can include vascularized bone from the mandibular margin. This flap exemplifies Gillies' principle of "replacing like with like" and should be discussed as an alternative to free tissue transfer in facial reconstruction, especially in settings where resources are limited.

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Submental Osteocutaneous Perforator Flap for Maxillary and Mandibular Reconstruction Following Tumor Resection

Cited by 9 publications

References 9 publications

Custom Presurgical Planning for Midfacial Reconstruction

Custom Presurgical Planning for Midfacial Reconstruction

Submental Artery Island Flap for Soft Tissue Coverage of a Mandibular Reconstruction Plate in a High-Risk Patient With Medication-Related Osteonecrosis of the Jaw

Twenty-Five Years of Experience with the Submental Flap in Facial Reconstruction: Evolution and Technical Refinements following 311 Cases in Europe and Africa

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