Article information, pdf download for submental island flap versus. Applied anatomy of the submental island flap and its clinical. The submental artery is a consistent branch of the facial artery. All patients who underwent reconstruction for head and neck defects with the submental island flap at the cancer center for guangxi medical university between january 2008 and may 2012 were observed. Submental island pedicled flap vs radial forearm free flap. Treatment of eccrine carcinoma of the chin via submental. The submental flap for head and neck reconstruction. Submental island flap versus free flap reconstruction for complex. The submental island flap in head and neck cancer faisal m. Pdf the submental island flap in head and neck cancer. Submental artery island flap vula university of cape town. Submental island flap reconstruction reduces cost in oral cancer reconstruction compared to radial forearm free flap reconstruction. The submental island flap smif is frequently utilized as an alternative to free tissue transfer ftt in oral cavity reconstruction.
Although submental island artery flap can be harvested for free tissue transfer, its main advantage for intraoral reconstruction is that it can be used as a pedicled flap and tunneled into the defect. A, flap size was notably larger for patients who underwent radial forearm free flap rfff compared with those who underwent submental island pedicled flap sipf p. The submental island flap in head and neck reconstruction. Mean operative time and duration of hospital stay were significantly shorter in the submental island flap group. However, its role in composite defects involving the jaw is not clearly defined.
Submental artery islandsubmental artery island flapflap department of oral and maxillofacial surgery vinnitsa national medical university presentation by, patrick royson albertina sheehama supervised by. Free flaps, such as the radial forearm and anterolateral thigh flap, have been the mainstay of complex head and neck reconstruction. For larger or more distant defects, an alternative reconstruction method or modification of this flap into a free flap should be considered. Submental artery island flap can be used as a pedicle or free flap. Indeed, controversy exists about the flap s interference with an oncologically sound neck dissection a total of 21 patients with oral cavity cancers over a three year period were. The hybrid submental flap for tongue reconstruction todd c. Reconstruction of the lip commissure with upper and lower lip.
Pdf the submental flap for oral cavity reconstruction. However, in highvolume and lowresource centers, various pedicled flaps continue to play a crucial role. Infantile myofibromatosis, myofibroma, mandibular reconstruction, submental island flap, fibula free flap introduction. The submental island flap is supplied by the submental artery, a branch of the facial artery. Submental island flap vs free tissue transfer in oral cavity. The submental artery island flap involves a relatively simple dissection, decreasing operative time, and avoiding microsurgical free tissue transfer. Mar 14, 2019 the strategy of staging mandibular reconstruction using a plate and submental island flap followed by a delayed fibula free flap is novel. 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.
Submental artery island flap in reconstruction of hard palate. Pertinent anatomy the submental island flap is an axial patterned flap based on the submental artery. In recent years, the submental island flap has demonstrated decreased cost and morbidity as compared with free tissue transfer and has. However, a local pedicled flap, such as the submental island flap sif, could be a more effective and less demanding alternative.
Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa, retromolar trigone, parotidectomy defects, and tongue. Infantile myofibromatosis treated by mandibulectomy and. The submental flap is gaining popularity as a simple technique for reconstruction. Submental artery island flap in reconstruction of hard. The submandibular gland was dissected and left free. Submental island pedicled flap vs radial forearm free flap for. The submental island flap is useful as an alternative to microvascular free tissue transfer for the reconstruction of defects after resection of oral cancer because it is simple to harvest. Since this description, the submental island has struggled to gain a strong foothold as a reliable flap in the. Submental artery island flap versus free flap reconstruction of lateral facial soft. Submental island flap versus free flap reconstruction for.
The submental island flap is a viable reconstructive option. Pdf the submental island flap for palatal reconstruction. The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. We collected wet specimens of fresh cadaveric heads from the han chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps. But there has been a relative paucity of information about the use of this flap in irradiated. Studies directly comparing smif and ftt for oral cavity defects were included. Pdf the submental flap is gaining popularity as a simple technique for reconstruction of small to. Submental artery island flap can be used as a pedicle or free flap 3. The submental island flap was first mentioned in the literature by martin et al. The nasolabial flap was rotated medially for reconstruction of the upper lip and then folded upon itself to form the inner and outer aspects of the upper lip. The submental island flap in lingual cancer reconstruction.
Hairbearing submental artery island flap for reconstruction. Reconstruction of an inferior orbital rim and cheek defect. Split thickness skin grafts, loco regional flaps, and free flaps have been. To our knowledge, this is the only reported case of fibula free flap mandibular reconstruction in a patient with im, as well as one of the youngest reported submental island flaps for any pathology. Island flap definition of island flap by medical dictionary. The submental island flap is a viable reconstructive.
Jan 12, 2015 chapter 14 submental island flap introduction. This paper describes the use of a new island flap based on the submental artery. Original article submental island pedicled flap vs radial. The submental island flap sif is a pedicled flap based upon the submental artery and vein. In the radial forearm free flap group, partial skin graft loss and arm function restriction were recorded. Accordingly, one might expect shorter operative time with the submental island pedicled flap sipf than is seen with free flap alternatives.
Rich vascular supply comes from subcutaneous muscular pedicle. The submental island flap for reconstruction of temporal bone. Original article the submental island flap in lingual cancer. The submental island flap was harvested figure 5, based on the submental branch of the ipsilateral side and after completion of the neck dissection, starting. Submental flap is a useful technique for reconstruction of medium to large oral cavity defects.
Hair bearing nature of this flap in men makes it less appropriate. The submental island flap journal of plastic, reconstructive. Table 2 shows various modifications of this flap 710. Blood supply of this flap can be retrograded based on facial artery or reverse flow based on angular artery 4,5. The submental island flap for palatal reconstruction. Since then, many other reports in the literature have confirmed its versatile use in head and neck reconstruction, and it is an excellent option for reconstruction of partial glossectomy defects. The skin territory of the single pedicle submental island flap is as large as 7. Feb 27, 2012 submental artery island flap can be used as a pedicle or free flap. Background the purpose of this study was to present the feasibility of reconstructing an inferior orbital rim and cheek defect with a pedicled osteomyocutaneous submental flap. To compare intraoperative, postoperative, functional, and oncologic outcomes of the submental island pedicled flap sipf to the radial forearm free flap rfff. Free flaps, such as the radial forearm and anterolateral thigh flap, have. The flap is drained by the submental vein, which in turn drains into the common facial vein on the surface of the submandibular gland. The submental island flap is a new alternative to the reconstruction of various head and neck defects.
Furthermore, only a single patient in the sif group required any intensive care monitoring, and in total spent a single day in the icu. The flap is drained through submental vein into the facial vein. The free skin flap when used in microvascular reconstruction technique may increase time and complexity of the process and carry an inherent. In direct comparison to radial forearm free flap reconstruction, submental island flap reconstruction was associated with shorter operative times and length of hospital stay. Its minimal donor site morbidity, excellent cosmetic match. The site of the tumour, the clinical stage, the technique of flap harvesting, the outcome of cosmesis and function were recorded. The submental flap provides an alternative technique in orofacial reconstruction, especially in situations where free flap. Over the past decade, the submental island flap has proved to be a. Submental artery island flap was first described by martin et al. Article information, pdf download for submental island flap. Summary the submental island flap is a reliable and versatile flap for head and neck reconstruction. In recent years, the submental island flap has demonstrated decreased cost and morbidity as compared with free tissue transfer and has been widely applied to a range of head and neck def. The mission of the ahns is to advance education, research, and quality of care for the head and neck oncology patient.
It has a long up to 8 cm consistent, reliable pedicle, and. Although submental island artery flap can be harvested for free tissue. Method a 77yearold women with a right nasosinusal adenoid cystic carcinoma invading soft tissues and skin of the cheek, the inferior rim of the orbit, the hard palate, and the middle turbinate is presented. Submental flap for soft tissue reconstruction following. The hybrid submental flap for tongue reconstruction. In the submental island flap group, all the flaps were successfully transferred with no donor site complications. Pedicled flap in lingual cancer reconstruction 14377 int j clin exp med 2016. Pdf submental island flap reconstruction reduces cost in.
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