Submental artery island flap with simultaneous level I neck dissection

Submental artery island flap with simultaneous level I neck dissection INTRODUCTIONThe submental flap, originally described my Martin et al in 1993, was developed because of its good color and texture match for facial defects with the added benefit of having a favorable concealed donor site scar. More recently, the flap was been used for oral cavity and oropharyngeal mucosal defects. The oncologic safety and adequacy of lymph node dissection has been demonstrated by multiple groups. The oncologic safety is less of a concern in the management of oropharyngeal, laryngeal, and hypopharyngeal compared with oral cavity tumors.The flap can be elevated with anterograde or retrograde flow. The retrograde flow modification was developed to provide an increased cephalad arc of rotation in the reconstruction of the upper face and more distal defects. However, using an anterograde hybrid flap, where the pedicle vein is divided and microvascularly anastomosed to a closer venous drainage system, can increase the pedicle length and arc of rotation by approximately 5 cm. Given that patients with head and neck cancer are often elderly with poor comorbidity profile, regional flaps are increasingly being considered to provide simpler reconstructive options.Patient informationAs an example, we chose 1 patient to demonstrate the technique. A 63‐year‐old patient with a T2N1M0 human papillomavirus‐positive squamous http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Head & Neck: Journal for the Sciences & Specialties of the Head and Neck Wiley

Submental artery island flap with simultaneous level I neck dissection

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1043-3074
eISSN
1097-0347
D.O.I.
10.1002/hed.25044
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONThe submental flap, originally described my Martin et al in 1993, was developed because of its good color and texture match for facial defects with the added benefit of having a favorable concealed donor site scar. More recently, the flap was been used for oral cavity and oropharyngeal mucosal defects. The oncologic safety and adequacy of lymph node dissection has been demonstrated by multiple groups. The oncologic safety is less of a concern in the management of oropharyngeal, laryngeal, and hypopharyngeal compared with oral cavity tumors.The flap can be elevated with anterograde or retrograde flow. The retrograde flow modification was developed to provide an increased cephalad arc of rotation in the reconstruction of the upper face and more distal defects. However, using an anterograde hybrid flap, where the pedicle vein is divided and microvascularly anastomosed to a closer venous drainage system, can increase the pedicle length and arc of rotation by approximately 5 cm. Given that patients with head and neck cancer are often elderly with poor comorbidity profile, regional flaps are increasingly being considered to provide simpler reconstructive options.Patient informationAs an example, we chose 1 patient to demonstrate the technique. A 63‐year‐old patient with a T2N1M0 human papillomavirus‐positive squamous

Journal

Head & Neck: Journal for the Sciences & Specialties of the Head and NeckWiley

Published: Jan 1, 2018

Keywords: ; ;

References

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