The submental island flap in head and neck reconstruction: A 10‐year experience examining application, oncologic safety, and role of comorbidity

Abstract

Background We present our experience on reconstructive versatility and risk of nodal transfer with the submental island flap (SIF). We also examine the role of comorbidity as a predictor of complications. Methods Retrospective cohort study of patients undergoing SIF over 10‐year period. Comorbidity determined using Adult Comorbidity Evaluation 27 index (ACE‐27). Univariable/multivariable logistic regressions performed to determine association of these characteristics and rates of major complications. Results Fifty‐eight patients underwent SIF reconstruction, 27 (45%) patients had moderate/severe comorbidity, and 24 (41%) experienced major complication. Multivariable analysis identified ACE‐27 scores >2 predictive of major flap complications (OR: 17.38, 95% CI: 1.96–153.74, p = .01) and medical complications (OR: 5.8, 95% CI: 1.11–30.23, p = .037). There were no cases of pathologic nodal transfer. Conclusion The SIF is a versatile flap and oncologically safe in carefully selected patients. The ACE‐27 index is strongly predictive of major postoperative complications. Level of Evidence 4

Repair defects after endoscopic debridement of head and neck cancer carcinoma with prior irradiation of submental flaps

“…Our ndings appear to corroborate those of other researchers who have demonstrated the clinical utility and safety of the SF in individuals who have had prior neck radiation [7,25].…”

“…Submental aps (SFs) have become a popular option in the fast-track surgery era for head and neck cancer. And there are also many bene ts, including shorter surgery time, less resource-intensive postoperative care, color and texture resembling the head and neck, even specialized operating room equipment, personnel, postoperative care and advanced microvascular fellowship training are usually not required [7,8].…”

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

“…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).…”

Carta al Editor: Un comentario acerca del colgajo submentoniano en la reconstrucción de cabeza y cuello

“…Paydarfar et al, 4 midieron la comorbilidad de los pacientes que serían sometidos a un colgajo submentoniano por medio del "Adult Comorbidity Evaluation 27 (ACE-27)", herramienta validada para pacientes con cáncer. Las condiciones comórbidas se clasifican como ninguna (0), leve (1), moderada (2) o grave (3).…”