The Submental Island Flap for Soft- Tissue Head and Neck Reconstruction: Step- by- Step Video Description and Long- Term Results
ABSTRACT A clinical case of a man undergoing radical parotidectomy with skin resection for an intraparotid recurrence of squamous cell carcinoma is presented. A step-by-step video description of the regional submental island flap, based on the right submental vessels, is presented and discussed. Long-term results at 1 year in terms of color match at the recipient and donor sites are excellent, along with no functional consequence.
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ABSTRACT: This paper describes the use of a new island flap based on the submental artery. Previously described cervical flaps have inherent problems ranging from limited mobility to unacceptable donor-site scars, to unpredictable outcomes. The flap design and technique were studied on 20 fresh cadavers and 8 patients who underwent radical neck dissections. The flap was then used successfully for reconstruction of orofacial defects in 8 patients. The flap has a long (up to 8 cm), reliable pedicle, and cutaneous dimensions can reach up to 7 x 18 cm. It can be used as a cutaneous, musculofascial (cervicofascial and platysma), or osteocutaneous flap. This flap has an excellent skin color match and a wide arc of rotation, and can extend to the whole homolateral face, except for a part of the forehead and the whole oral cavity. The anatomy, the technique, and clinical experiences are presented.Plastic & Reconstructive Surgery 11/1993; 92(5):867-73. DOI:10.1097/00006534-199392050-00013 · 3.33 Impact Factor
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ABSTRACT: Following excisional surgery for head and neck cancer, most complex defects are reconstructed using microvascular free tissue transfer. These methods offer many advantages; however, they are of increasing complexity with attendant risks of flap loss and donor site problems. The submental artery island flap is a recently described local flap that may be used for reconstruction of the lower and middle thirds of the face and oral cavity, and offers the advantages of simplicity, reliability and excellent cosmesis. We have been using this flap as an alternative to free tissue transfer, and in this paper we present our series of 11 cases, after a review of the recent literature, anatomy and surgical technique. The advantages and limitations of the use of this flap are presented. A consecutive series of 11 patients in which this reconstruction was performed was reviewed retrospectively, and the results studied. Advantages and disadvantages of this reconstructive method were determined to define appropriate indications and contra-indications for its use. We have used this flap in 11 patients for post-excisional soft tissue reconstruction of the head and neck, both as skin and as a mucosal replacement. In all but two patients the results were satisfactory, with excellent cosmesis when used as skin replacement. One patient required secondary debulking and one had complete flap loss. In all, the donor site was satisfactory. The Submenal Artery Island Flap is a useful addition to the reconstructive surgeon's options and has definite advantages over distant flaps in terms of ease of dissection, final cosmetic appearance and donor site appearance.ANZ Journal of Surgery 03/2002; 72(2):121-4. DOI:10.1046/j.1445-2197.2002.02318.x · 1.12 Impact Factor
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ABSTRACT: This article reviews the submental island flap, focusing on its relevant surgical anatomy, surgical technique, and recent applications in head and neck reconstruction. Reconstruction of defects after extirpation of head and neck neoplasms is a highly challenging and complex surgical undertaking. Various techniques, including skin grafts, regional flaps, and free tissue transfer, can be employed in the restoration of function and cosmesis after ablative surgery. However, commonly used techniques, such as the radial forearm flap or anterior lateral thigh flap, share numerous disadvantages, such as donor-site morbidity, poor color match for cutaneous reconstruction, and excessive tissue bulk for intraoral reconstruction, making ideal replacement of 'like with like' elusive. The use of a submental artery island flap is a relatively new and an increasingly popular option for head and neck reconstruction that provides an additional reconstructive option. The submental island flap is a reliable and versatile flap for head and neck reconstruction. Its minimal donor site morbidity, excellent cosmetic match, pliability, and relative ease of dissection and application has a definite advantage over distant flaps, making it an excellent addition to the reconstructive armamentarium of the head and neck surgeon.Current opinion in otolaryngology & head and neck surgery 06/2009; 17(4):263-6. DOI:10.1097/MOO.0b013e32832cee83 · 1.39 Impact Factor