The Extended Submental Island Lip Flap: An Alternative for Esophageal Repair

Janssen, David A.; Thimsen, Daniel A.

doi:10.1097/00006534-199809010-00034

Cited by 15 publications

(3 citation statements)

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“…27,29,30 However, a high success and low complication rate has been reported for both methods. [22][23][24][25][26][27][28][29] The lateral island trapezius myocutaneous flap, 31 the extended submental island flap, 32 and the pectoralis major myocutaneous flap 33,34 are reported to be alternative methods for cervical oesophageal reconstruction, and might be suitable also in trauma situations. However, the data available on these procedures for the particular indication of post-traumatic oesophageal repair are limited.…”

Section: Discussionmentioning

confidence: 99%

Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature

Erdmann

et al. 2003

Spinal Cord

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Study design: Single-subject (male, 16 years of age) case. Objectives: To demonstrate a suitable method for oesophageal repair after perforation as a complication of anterior spinal fusion in an individual with quadriplegia, and to review the literature on oesophageal perforation and repair. Setting: University hospital, large trauma centre with departments for spinal injuries and reconstructive surgery in Germany. Methods: A free jejunal graft used for oesophageal reconstruction in a post-traumatic situation after a complicated treatment course in a C6 quadriplegic patient. Results: A protuberant loose screw of the titanium plate after anterior spinal fusion perforated the oesophagus. Imbricating sutures and a fascia lata patch were insufficient to repair the oesophageal leakage. An 8 cm long segment of the cervical oesophagus including a fistula had to be excised, and a free microsurgical jejunal flap was used for restitution of continuity. The jejunal vessels were connected to the superior thyroid artery and external jugular vein. At 1 week after the oesophageal repair, an enteral contrast study showed a small amount of contrast medium leaking at the oesophago-pharyngeal anastomosis. A percutaneous gastric tube was inserted, and oral feeding was limited to tea and still water for 4 weeks. The further course was uneventful. Conclusions: Oesophageal perforation is a rare but recognized complication after cervical spine surgery, which can mostly be managed using secondary suture techniques. The free jejunal flap is a reliable and innovative tool in the particularly complex situation of a segmental oesophageal loss. It should be considered in similar cases to reconstruct oesophageal continuity or to treat stricture and fistula formations.

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Section: Discussionmentioning

confidence: 99%

Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature

Erdmann

et al. 2003

Spinal Cord

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“…Another surgical option for closure is an island submental flap. 12 The majority of the fistulas appear between 7 and 13 postoperative days. In different studies it is 40 postoperative days to 3 months but it is logical to optimize the surgical bed first before surgical repair.…”

Section: Discussionmentioning

confidence: 99%

Pharyngocutaneous fistula repair: case report and review of management strategies

Nagarkar

Kokane

Wagh

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract"><span lang="EN-IN">Incidence of post chemoradiation salvage laryngectomy complication rate is 3%-65%. It is most common but most annoying complication after salvage laryngectomy for surgeon to manage. When conservative measures fail to repair the fistula surgical means have to be considered. But even after surgical correction it takes time to heal due to local conditions. Here we present a case of surgical repair of pharyngocutaneous fistula and review of various management strategies.</span></p>

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“…9,29,30 The SAIF may be employed for several purposes, mainly as myocutaneous, but also as fasciocutaneous, osteocutaneous or cutaneous flap, 31 and it has been described for reconstruction of head and neck soft tissue defects of the lower, mid and upper region of the face (which may require division of the facial artery and vein). It has also been used for malar augmentation with fascia flap only, 29,32 reconstruction of defects with hair-bearing skin, 33 tongue and/or floor of mouth defects, buccal mucosa defects, palatal defects, 34 nasal reconstruction, 35 lip reconstruction, [36][37][38] cervical esophagus repair or reconstruction, [39][40][41] hemilaryngectomy defects repair, 31 reconstruction of the neopharynx after total laryngectomy, repair of pharyngocutaneous fistulas 42 and coverage of hardware used in spine surgery. 43 There is controversy in the literature about the oncological safety of the SAIF due to the relationship between the flap and lymph nodes of the Ib region, because these nodal levels might be involved even at an early stage of OSCC, 44,45 and this can increase the risk of recurrence, 44,46,47 as well as hindering a rigorous cervical level I neck dissection.…”

Section: Discussionmentioning

confidence: 99%

Submental Artery Island Flap in Oral Cavity Reconstruction. An Observational, Retrospective Two-centre Study

Ramírez

Chiesa‐Estomba²,

González-García³

2020

Int Arch Otorhinolaryngol

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Introduction The submental flap provides an alternative technique in orofacial reconstruction, especially in situations in which free flaps are not available, or the patients are unfit. Objective To demonstrate the oncological safety and benefits of this flap in oral cavity reconstruction. Methods A total of 14 patients with oral cavity cancers, who underwent submental flap reconstruction from January 2016 to January 2018, were included in the study. Results There were 11 male and 3 female patients with a mean age of 66.7 ± 14 (Min: 52/Max: 91) years old. The most common primary tumor site was the mobile tongue in 12 (85.7%) patients. All of the patients underwent ipsilateral selective neck dissection after the flap was harvested. Flap partial necrosis was observed in one patient, and total necrosis in another one. The mean follow-up was of one year. Nonlocal or regional recurrences were observed. Conclusion Submental island flap represents a good option in oral cavity reconstruction in a restricted setting or in patients considered not fit for free flap reconstruction. Preoperative selection of clinically neck node-negative patients is essential due to the potential risk of occult metastasis.

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The Extended Submental Island Lip Flap: An Alternative for Esophageal Repair

Cited by 15 publications

References 0 publications

Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature

Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature

Pharyngocutaneous fistula repair: case report and review of management strategies

Submental Artery Island Flap in Oral Cavity Reconstruction. An Observational, Retrospective Two-centre Study

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