The Submental Island Flap for Soft- Tissue Head and Neck Reconstruction: Step- by- Step Video Description and Long- Term Results

Université de Montréal, Montréal, Quebec, Canada
Plastic and Reconstructive Surgery (Impact Factor: 2.99). 03/2014; 133(3):684-6. DOI: 10.1097/PRS.0000000000000058
Source: PubMed


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.
Therapeutic, V.

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Available from: Sami Moubayed, Sep 22, 2015
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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 &amp Reconstructive Surgery 11/1993; 92(5):867-73. DOI:10.1097/00006534-199392050-00013 · 2.99 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: The submental flap, based on a large branch of the facial artery, is an excellent flap option which is most commonly used for head and neck reconstruction. The purpose of this report is to clarify aspects of the anatomy of the submental flap in order to improve the utility of this flap. Ten cadavers were injected with a modified lead oxide-gelatin mixture. Four cadavers were selected for three-dimensional reconstruction using a spiral computed tomography scanner and specialised volume-rendering software. Dissection, angiography and photography of each layer were performed to outline the course of every perforator in the neck. The area of the vascular territory supplied by each source vessel was calculated. Surface areas were measured using Scion Image software. The skin and muscles on the anterior neck and mandible are nourished by several arterial perforators: facial artery, superior thyroid artery, mental artery, lingual artery and the submental artery. The diameter of the submental artery was 1.7 ± 0.4mm at its origin from the facial artery. It sends 1.8 ± 0.6 perforators to the skin on its course towards the chin. The average size of the territory supplied was 45 ± 10.2 cm(2). Its largest perforating branch arises from behind the medial border of the anterior belly of the digastric muscle. There were multiple anastomoses between perforators from the submental artery, facial artery and sublingual artery. This study clarifies the anatomy of the submental flap and provides a three-dimensional understanding to this important head and neck donor site.
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