SUBMENTAL ISLAND FLAP FOR REPAIR OF ORAL DEFECTS AFTER RADICAL RESECTION OF EARLY-STAGE ORAL SQUAMOUS CELL CARCINOMA_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Hanqian , YU Huiming , LIU Jiawu.

Department of Stomatology, Huai’an First Hospital Affiliated to Nanjing Medical University, Huai’an Jiangsu, 223300, P.R.China. Corresponding author: LIU Hanqian, E-mail: liuhq67@163.com;

Corresponding author：

Keywords：

Submental island flap; Maxillofacial defect repair; Oral squamous cell carcinoma

DOI：

10.7507/1002-1892.20130240

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Objective To evaluate the effectiveness of the submental island flap for repair of oral defects after radical resection of early-stage oral squamous cell carcinoma (OSCC). Methods Between February 2010 and August 2011, 15 cases of early-stage OSCC were treated. Of 15 cases, 9 were male and 6 were female, aged from 48 to 71 years (mean, 63 years). The disease duration was 28-73 days (mean, 35 days). Primary lesions included tongue (3 cases), buccal mucosa (8 cases), retromolar area (2 cases), and floor of mouth mucosa (2 cases). According to TNM classification of International Union Against Cancer (UICC, 2002) of oral cancer and oropharyngeal cancer, 2 cases were classified as T1N0M0 and 13 cases as T2N0M0. The results of the pathologic type were high differentiated squamous cell carcinoma in 11 cases and moderately differentiated squamous cell carcinoma in 4 cases. The defect after resection of the lesion ranged from 5 cm × 3 cm to 8 cm × 6 cm. All the cases underwent radical resection of the primary lesion and immediate reconstruction with submental island flap except 1 case with radial forearm free flap because of no definite venous drainage. The sizes of the submental island flap varied from 6 cm × 4 cm to 9 cm × 6 cm. Results Operation time ranged from 4 hours and 30 minutes to 7 hours and 10 minutes (mean, 5 hours and 53 minutes) in 14 cases undergoing repair with submental island flap. All the flaps survived completely in 13 cases except 1 case having superficial necrosis of the flap, which was cured after conservative treatment. Temporary marginal mandibular nerve palsy occurred in 1 case, and was cured after 3 months; submandibular effusion was observed in 3 cases, and was cured after expectant treatment. The follow-up period ranged from 8 to 15 months (mean, 10.5 months) in 14 cases undergoing repair with submental island flap. Hair growth was seen on the flap and became sparse after 3 months in 2 male cases. The appearance of the face, opening mouth, swallowing, and speech were recovered well in 14 cases, and the donor site had no obvious scar. The follow-up period was 13 months in 1 case undergoing repair with radical free forearm flap, and the appearance and function were recovered well. No local recurrence was found during follow-up. Conclusion The submental island flap has reliable blood supply, and could be harvested simply and rapidly. It can be used to repair oral defects in patients with early-stage OSCC after radical resection.

Citation： LIU Hanqian,YU Huiming,LIU Jiawu.. SUBMENTAL ISLAND FLAP FOR REPAIR OF ORAL DEFECTS AFTER RADICAL RESECTION OF EARLY-STAGE ORAL SQUAMOUS CELL CARCINOMA. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(9): 1098-1101. doi: 10.7507/1002-1892.20130240 Copy

1.	Vural E, Suen JY. The submental island flap in head and neck reconstruction. Head Neck, 2000, 22(6): 572-578.
2.	Martin D, Pascal JF, Baudet J, et al. The submental island flap: A new donor site: anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg, 1993, 92(5): 867-873.
3.	You YH, Chen WL, Wang YP, et al. The feasibility of facial-submental artery island myocutaneous flaps for reconstructing defects of the oral floor following cancer ablation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(6): e12-16.
4.	Paydarfar JA, Patel US. Submental island pedicled falps vs radical forearm free flap for oral reconstruction: comparisn of outcomes. Arch Otolaryngol Head Neck Surg, 2011, 137(1): 82-87.
5.	Wang JG, Chen WL, Ye HS, et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation. J Craniomaxillofac Surg, 2011, 39(7): 499-502.
6.	Zhang B, Wang JG, Chen WL, et al. Reverse facial-submental artery island flap for reconstruction of oropharyngeal defects following middle and advanced-stage carcinoma ablation. Br J Maxillofac Surg, 2011, 49(3): 194-197.
7.	梁衍灿, 黄汉民, 陈伟良, 等. 面动脉-颏下动脉岛状皮瓣修复半舌缺损. 口腔颌面外科杂志, 2010, 20(4): 262-265.
8.	Curran AJ, Neligan P, Gullane PJ. Submental island flap. Laryngoscop, 1997, 107(11 Pt 1): 1545-1549.
9.	Higgins KM, Backstein R. The submental island flap: A regional and free flap with amyriad of reconstructive applications. J Otolaryngol, 2007, 36(2): 88-92.
10.	Sebastian P, Thomas S, Varghese BT, et al. Thesubmental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol, 2008, 44(11): 1014-1018.
11.	Faltaous AA, Yetman RJ. The submental artery flap: an anatomic study. Plast Reconstr Surg, 1996, 97(1): 56-60.
12.	张海明, 严义坪, 孙广慈, 等. 颏下组织瓣的应用解剖学. 中华整形烧伤外科杂志, 1997, 13(4): 288-290.
13.	高银光, 范飞, 尤建军, 等. 颏下皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2006, 24(1): 54-56.
14.	Uppin SB, Ahmad QG, Yadav P, et al. Use of the submental island flap inorafacial reconstruction-a review of 20 cases. J Plast Reconstr Aesthet Surg, 2009, 62(4): 514-519.
15.	Pistre V, Pefissier P, Martin D, et al. The submental flap: its uses as a pedicled or free flap for facial reconstruction. Clin Plast Surg, 2001, 28(2): 303-309.
16.	Aboucbadi A, Capen-Degardin N, Patenotre P, et al. The submental flap in facial reconstruction: advantage and limitations. J Oral Maxillofac Surg, 2007, 65(5): 863-869.
17.	吴跃煌, 唐平章, 祁永发, 等. 颏下岛状皮瓣应用结果回访. 中华口腔医学杂志, 2002, 37(6): 418-420.
18.	Chen WL, Li JS, Yang ZH, et al. Two submental island flaps for reconstructing oral maxillofacial defects following cancer ablation. J Oral Maxillofac Surg, 2008, 66(6): 1145-1156.
19.	张翠翠, 王建广, 乐志亮, 等. 颏下岛状肌皮瓣修复口腔颌面部缺损的临床观察. 中华耳鼻咽喉头颈外科杂志, 2012, 47(4): 285-288.
20.	张继生, 尹林, 卜寿山, 等. 原发灶对侧血管蒂颏下岛状皮瓣修复口底区恶性肿瘤术后缺损的临床应用. 江苏医学, 2011, 37(15): 1773-1774.
21.	潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 2011, 38(1): 22-23, 26.

1. Vural E, Suen JY. The submental island flap in head and neck reconstruction. Head Neck, 2000, 22(6): 572-578.
2. Martin D, Pascal JF, Baudet J, et al. The submental island flap: A new donor site: anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg, 1993, 92(5): 867-873.
3. You YH, Chen WL, Wang YP, et al. The feasibility of facial-submental artery island myocutaneous flaps for reconstructing defects of the oral floor following cancer ablation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(6): e12-16.
4. Paydarfar JA, Patel US. Submental island pedicled falps vs radical forearm free flap for oral reconstruction: comparisn of outcomes. Arch Otolaryngol Head Neck Surg, 2011, 137(1): 82-87.
5. Wang JG, Chen WL, Ye HS, et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation. J Craniomaxillofac Surg, 2011, 39(7): 499-502.
6. Zhang B, Wang JG, Chen WL, et al. Reverse facial-submental artery island flap for reconstruction of oropharyngeal defects following middle and advanced-stage carcinoma ablation. Br J Maxillofac Surg, 2011, 49(3): 194-197.
7. 梁衍灿, 黄汉民, 陈伟良, 等. 面动脉-颏下动脉岛状皮瓣修复半舌缺损. 口腔颌面外科杂志, 2010, 20(4): 262-265.
8. Curran AJ, Neligan P, Gullane PJ. Submental island flap. Laryngoscop, 1997, 107(11 Pt 1): 1545-1549.
9. Higgins KM, Backstein R. The submental island flap: A regional and free flap with amyriad of reconstructive applications. J Otolaryngol, 2007, 36(2): 88-92.
10. Sebastian P, Thomas S, Varghese BT, et al. Thesubmental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol, 2008, 44(11): 1014-1018.
11. Faltaous AA, Yetman RJ. The submental artery flap: an anatomic study. Plast Reconstr Surg, 1996, 97(1): 56-60.
12. 张海明, 严义坪, 孙广慈, 等. 颏下组织瓣的应用解剖学. 中华整形烧伤外科杂志, 1997, 13(4): 288-290.
13. 高银光, 范飞, 尤建军, 等. 颏下皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2006, 24(1): 54-56.
14. Uppin SB, Ahmad QG, Yadav P, et al. Use of the submental island flap inorafacial reconstruction-a review of 20 cases. J Plast Reconstr Aesthet Surg, 2009, 62(4): 514-519.
15. Pistre V, Pefissier P, Martin D, et al. The submental flap: its uses as a pedicled or free flap for facial reconstruction. Clin Plast Surg, 2001, 28(2): 303-309.
16. Aboucbadi A, Capen-Degardin N, Patenotre P, et al. The submental flap in facial reconstruction: advantage and limitations. J Oral Maxillofac Surg, 2007, 65(5): 863-869.
17. 吴跃煌, 唐平章, 祁永发, 等. 颏下岛状皮瓣应用结果回访. 中华口腔医学杂志, 2002, 37(6): 418-420.
18. Chen WL, Li JS, Yang ZH, et al. Two submental island flaps for reconstructing oral maxillofacial defects following cancer ablation. J Oral Maxillofac Surg, 2008, 66(6): 1145-1156.
19. 张翠翠, 王建广, 乐志亮, 等. 颏下岛状肌皮瓣修复口腔颌面部缺损的临床观察. 中华耳鼻咽喉头颈外科杂志, 2012, 47(4): 285-288.
20. 张继生, 尹林, 卜寿山, 等. 原发灶对侧血管蒂颏下岛状皮瓣修复口底区恶性肿瘤术后缺损的临床应用. 江苏医学, 2011, 37(15): 1773-1774.
21. 潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 2011, 38(1): 22-23, 26.

Chinese Journal of Reparative and Reconstructive Surgery

SUBMENTAL ISLAND FLAP FOR REPAIR OF ORAL DEFECTS AFTER RADICAL RESECTION OF EARLY-STAGE ORAL SQUAMOUS CELL CARCINOMA

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