The submental flap – Outcomes and oncologic safety in head and neck reconstruction
Introduction: The submental flap is a reliable alternative to free flaps in the reconstruction of cutaneous facial and oral cavity defects. The thin, pliable, easily harvested flap has minimal donor site morbidity. The flap is controversial due to the potential involvement of level I lymph nodes wit...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Advances in Oral and Maxillofacial Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667147621000698 |
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| author | Chandra Mohan LN. Setty Vidya Konduru Amit Jiwan Tirkey Mansi Agrawal Philip George Rajinikanth J |
| author_facet | Chandra Mohan LN. Setty Vidya Konduru Amit Jiwan Tirkey Mansi Agrawal Philip George Rajinikanth J |
| author_sort | Chandra Mohan LN. Setty |
| collection | DOAJ |
| description | Introduction: The submental flap is a reliable alternative to free flaps in the reconstruction of cutaneous facial and oral cavity defects. The thin, pliable, easily harvested flap has minimal donor site morbidity. The flap is controversial due to the potential involvement of level I lymph nodes within the flap. We describe 40 cases of head and neck reconstruction with the submental flap following resection of various cancers, and assess the oncologic safety of this flap at our centre. Aims: To evaluate the outcomes of the submental flap and assess the oncologic safety of the flap on follow-up. Material and methods: Pre-operative, post-operative and follow-up data of 40 consecutive patients with oral cavity and parotid malignancies, who underwent reconstruction with the submental flap between January 2017 and June 2019, was analysed. Results: Oral cavity defects following resection of carcinoma tongue were predominant (n = 19). Patients were considered suitable for reconstruction with the submental flap only when level Ia and Ib nodes were clinically and radiologically negative for metastasis. Neck dissection was performed in all cases, with careful dissection of all level Ib nodes along the submental perforators. Flap complications were minimal. During a mean follow-up period of 14 months, no recurrences were noted within the flap. Conclusions: The submental flap, although not the first choice, is a reliable alternative to free flaps in the reconstruction of oral defects. However, selection of patients with clinically node negative disease is extremely important, due to the potential risk of occult metastasis. |
| first_indexed | 2024-12-13T20:08:24Z |
| format | Article |
| id | doaj.art-0b4925a47412450daaafe1279defc232 |
| institution | Directory Open Access Journal |
| issn | 2667-1476 |
| language | English |
| last_indexed | 2024-12-13T20:08:24Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Oral and Maxillofacial Surgery |
| spelling | doaj.art-0b4925a47412450daaafe1279defc2322022-12-21T23:32:58ZengElsevierAdvances in Oral and Maxillofacial Surgery2667-14762021-07-013100082The submental flap – Outcomes and oncologic safety in head and neck reconstructionChandra Mohan LN. Setty0Vidya Konduru1Amit Jiwan Tirkey2Mansi Agrawal3Philip George4Rajinikanth J5Department of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaCorresponding author. Department of Head and Neck Surgery, Unit-2, # 1207, 2ndfloor, Paul Brand Building, Christian Medical College – Hospital Campus, Vellore, Tamil Nadu, 632004, India.; Department of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaDepartment of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaDepartment of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaDepartment of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaDepartment of Head and Neck Surgery, Unit-2, Christian Medical College, Vellore, Tamil Nadu, 632004, IndiaIntroduction: The submental flap is a reliable alternative to free flaps in the reconstruction of cutaneous facial and oral cavity defects. The thin, pliable, easily harvested flap has minimal donor site morbidity. The flap is controversial due to the potential involvement of level I lymph nodes within the flap. We describe 40 cases of head and neck reconstruction with the submental flap following resection of various cancers, and assess the oncologic safety of this flap at our centre. Aims: To evaluate the outcomes of the submental flap and assess the oncologic safety of the flap on follow-up. Material and methods: Pre-operative, post-operative and follow-up data of 40 consecutive patients with oral cavity and parotid malignancies, who underwent reconstruction with the submental flap between January 2017 and June 2019, was analysed. Results: Oral cavity defects following resection of carcinoma tongue were predominant (n = 19). Patients were considered suitable for reconstruction with the submental flap only when level Ia and Ib nodes were clinically and radiologically negative for metastasis. Neck dissection was performed in all cases, with careful dissection of all level Ib nodes along the submental perforators. Flap complications were minimal. During a mean follow-up period of 14 months, no recurrences were noted within the flap. Conclusions: The submental flap, although not the first choice, is a reliable alternative to free flaps in the reconstruction of oral defects. However, selection of patients with clinically node negative disease is extremely important, due to the potential risk of occult metastasis.http://www.sciencedirect.com/science/article/pii/S2667147621000698Submental flapOral cavity reconstructionOral squamous cell carcinomaRegional flapsOncological safety of flaps |
| spellingShingle | Chandra Mohan LN. Setty Vidya Konduru Amit Jiwan Tirkey Mansi Agrawal Philip George Rajinikanth J The submental flap – Outcomes and oncologic safety in head and neck reconstruction Advances in Oral and Maxillofacial Surgery Submental flap Oral cavity reconstruction Oral squamous cell carcinoma Regional flaps Oncological safety of flaps |
| title | The submental flap – Outcomes and oncologic safety in head and neck reconstruction |
| title_full | The submental flap – Outcomes and oncologic safety in head and neck reconstruction |
| title_fullStr | The submental flap – Outcomes and oncologic safety in head and neck reconstruction |
| title_full_unstemmed | The submental flap – Outcomes and oncologic safety in head and neck reconstruction |
| title_short | The submental flap – Outcomes and oncologic safety in head and neck reconstruction |
| title_sort | submental flap outcomes and oncologic safety in head and neck reconstruction |
| topic | Submental flap Oral cavity reconstruction Oral squamous cell carcinoma Regional flaps Oncological safety of flaps |
| url | http://www.sciencedirect.com/science/article/pii/S2667147621000698 |
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