Is submental flap safe for the oncological reconstruction of the oral cavity?

Abstract

Aim: The reconstruction of oral defects after oncological surgery is not an easy task for head and neck surgeons. The main aim of this work is to evaluate the functionality, viability and safety of submental flap for oral reconstruction.

Materials and method: We analyzed the records of patients diagnosed with oral and oropharyngeal SCC and reconstructed with the use of submental flap in Virgen de las Nieves University Hospital of Granada (Spain) from 2014 and 2015. Nine patients were found. Specific features such as age, sites of occurrence, sex distribution, T stage at diagnosis, nodal involvement, functionality of reconstruction and local and regional failure were determined.

Results: The male/female ratio was 8:1. The average age of the patients was 59.6 years (range: 42-75). Tumor locations were base of the tongue (n2), lateral edge of the tongue (n4), floor of the mouth (n2) and buccal mucosa (n1). Six tumors were classified as a T2 tumor and 3 as T3. No major complications were evidenced during the immediate postoperative period. Moreover, all patients showed excellent tissue coverage with acceptable aesthetic and functional outcomes. However, 1 patient showed partial epithelial loss of the skin paleta. Finally, the recurrence rate of disease was 44,4%. Four of 9 patients experienced a local (1/9) or cervical relapse (3/9).

Discussion: Submental flap might offer great aesthetic and functional results in oral reconstruction. However, the recurrence rate of disease was too high in our sample. From our point of view, submental flap should be carefully indicated in oncological reconstruction, especially in case of suspicion of lymph node involvement at level Ib.

Keywords: Head and neck reconstruction; Oncological safety; Recurrence rate; Submental flap.