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Resumen La cirugía reconstructiva de cabeza y cuello es una tarea compleja. Existen varias opciones disponibles para lograr buenos resultados, desde colgajos locales hasta colgajos libres microvascularizados. En este reporte presentamos nuestra experiencia utilizando el colgajo en isla submental para la reconstrucción de defectos de tejido blando de base de cráneo lateral posterior a una resección lateral de hueso temporal secundario a diagnósticos oncológicos otológicos. Se presentan datos demográficos, clínicos, quirúrgicos y resultados de dos pacientes intervenidos durante el primer semestre del año 2020, en los cuales se consiguió un adecuado resultado reconstructivo. Este colgajo es una opción confiable y versátil para reconstrucción en cabeza y cuello.
Abstract Reconstructive head and neck surgery is a complex task. There are several options available to achieve good results, from local flaps to free microvascular flaps. In this article, we present our experience using the submental island flap for soft tissue defect reconstruction of the lateral skull base after a lateral temporal bone resection secondary to otologic cancer. Demographic, clinical, surgical and outcome data of two patients operated on during the first semester of 2020 are presented, in whom a good reconstructive result was achieved. This flap is a reliable and versatile option for head and neck reconstruction.
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Objective To summarize the surgery skills and evaluate the clinical outcome of submental island flap for repairing oral defect after radical resection of oral cancer. Methods A total of 25 consecutive patients underwent submental island flap reconstruction after ablative surgery for oral cancer from January 2015 to May 2017 were enrolled in this study. The patterns of venous return, the technique notes and postoperative complications were summarized. The oncological safety of submental island flap in oral reconstruction was analyzed. Results The submental island flaps were harvested with the sizes ranging from(5 cm×3 cm)to(12 cm×5 cm).The mean operation time was(350.5±50.5)min.The vein of the flap was found to drain into the facial vein,and then returned to the internal jugular vein in 17 patients(68.0%), into the external jugular vein in 4 patients(16%),and into the anterior jugular vein in 4 patients(16%).Twenty-four flaps survived completely,and 1 flap failed due to the damage of the submental artery.Wound infection occurred in only 1 patient, and primary wound healing was observed in the other 24 patients. Eight patients (32.0%) with cervical lymph node metastases were verified by the postoperative pathological examination, 4 patients were submandibular lymph node metastases.The prevalence of occult lymph node metastasis involving level Ⅰwas 16.0%.The mean follow-up period was (14.3 ± 5.2) months. Local recurrence was found in 1 patient and cervical recurrence in 2 patients without postoperative radiotherapy during the follow-up. Conclusion There are three various drainage patterns for the venous return of submental island flap.Our data suggest that vein drainage of the flap into the external jugular vein and the anterior jugular vein,which are previously overlooked,should receive greater attention during the harvest of submental flap to avoid venous congestion and flap loss.Close follow-up or postoperative radiotherapy are recommended for patients without cervical lymph node metastases.
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Objective To explore the effect of the submental island flap in reconstruction of facial defects. Methods Six patients (4 men and 2 women) with lesions in maxillofacial regions were registried in our clinical database. Patients age ranged from 44 to 78 years, lesions were distributed in left face (2 cases), left parotid area (1 case), right parotid area (1 case), and right face (2 cases). The pathologic diagnoses were dermoid cyst with local skin necrosis (1 case ), sebaceous cyst with inflammation and necrosis (1 case), canceration of epithelial tumor (1 case) and squamous cell carcinoma (3 cases). The benign tumors were resected and malignant tumors were extensively resected with neck dissection. The defects (minimum 4.0 cm?3.0 cm, maximum 6.0 cm?6.0 cm ) after surgical resection were reconstructed with the submental island flap. The flap area ranged from 4.5 cm? 3.0 cm to 6.0 cm?4.5 cm. The flap pedicle included submental artery (3 cases) and both submental artey and facial artery ( 3 cases ). The length from end of flaps to origin of pedicle was 6 cm in 3 cases,9 cm in 2 cases and 11 cm in 1 case. Results The flaps survived in all six cases, no obvious difference in colour was found between the flaps and facial skin; no infection at recipient site, unhealed and necrosis occurred. The wounds of donor sites were primarily healed, and the scar of donor site was out of sight when looked with eyesight parallel to the ground. Conclusion It is an ideal method to reconstruct facial defects with submental island flap.