The submental island flap in head and neck reconstruction

The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates

“…In our view it is an additional benefit of the SMI-flap that its elevation can combined with submandibular lymph node dissection usually resulting in an acceptable cosmesis of the donor site [16,17]. We consider it as an important advantage of the SMI-flap to other local flaps of the skin of the anterior neck (such as platysma flaps and supraclavicular flaps) that the SMI-flap provides an appropriate mobility to treat all regions of the oral cavity [18].…”

The submental island flap in head and neck reconstruction

“…It may be superficial (30%) [4] or deep to the digastric muscle (70%) [4] and ends behind the symphysis of the mandible on the anterior belly of the digastric, from where it sends branches to the lower lip and sublingual gland. As it courses, the submental artery gives off 1-4 cutaneous perforators [5], which pierce the platysma and terminate in a subdermal plexus connected with the contralateral artery, thus supplying almost the entire skin of the hemineck with reliable random perfusion of the contralateral hemineck [6]. This zone of perfusion allows a large flap to be raised from mandibular angle to angle, with the width determined by the laxity of the neck skin allowing primary closure, affording a flap as large as 18 cm (length) Â 7 cm (width) [6].…”

“…The vascular pedicle length can range up to 8 cm [6], providing an arc of rotation extending from the medial canthus to the zygomatic arch [7]. Division of the facial vessels distal to the origin of the submental artery affords an additional 1-2 cm of length [5] (Fig. 1) [8].…”

“…One of the greatest attributes of the submental island flap is the excellent color, contour, and texture match between the donor and the recipient site [1,2,5]. Although originally introduced for facial defects because of these attributes [2], the flap has since been used in numerous additional settings (Table 1 [1,4,5-8,9 ,10-15]).…”

Submental Flap in Intraoral Reconstruction After Pathologic Resections: Indications and Limitations

“…The former is based on angular artery and depends on anastomosis between internal and external carotid arteries. The latter is the one mostly used for intraoral reconstructions [4,5]. Free submental tissue transfer is not indicated for intraoral reconstructions because of vicinity of donor site to oral cavity.…”