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Submental flap

P Sittitrai, C Srivanitchapoom, D Reunmakkaew, K Yata
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, reliable, and is associated with good oral function and low morbidity. However, because cancer of the oral cavity carries a risk of level I nodal metastases, the oncological safety of the flap remains controversial. Between April 2012 and September 2016, we studied patients with squamous cell carcinoma of the oral cavity who underwent surgical resection with submental island flap reconstruction for viability of the flap, signs of recurrence, and complications...
November 19, 2016: British Journal of Oral & Maxillofacial Surgery
Shaji Thomas, Bipin T Varghese, S Alagu Ganesh, Kapil Prabhu Desai, Elizabeth Mathew Iype, P G Balagopal, Paul Sebastian
Submental artery island flap (SMIF) is gaining popularity as a viable alternative to free flaps in carefully selected oral cavity defects after surgical extirpation of cancers.The current paper looks into the overall efficacy and oncological safety of the flap based on a prospective audit of 229 cases done at a high volume cancer center from october 2004 to september 2012 and concludes that SMIF is a oncologically safe,reliable reconstructive option in carefully selected oral cancers undergoing surgical resections...
December 2016: Indian Journal of Surgical Oncology
Kate Clancy, Camille Huwyler, Shawn Li, Jeffrey Otiti, Chad A Zender
BACKGROUND: The goals of successful reconstructive surgery are to restore function and cosmesis; however, limitation of resources can become an important consideration in low-middle income countries. METHODS: We describe our experience using the submental island flap in two cases during a short-term surgical camp in East Africa. RESULTS: The submental island flap was utilized as an excellent alternative to a free flap to reconstruct a subtotal maxillectomy and a parotidectomy defect in two patients...
September 28, 2016: American Journal of Otolaryngology
Ning Ma, Yang Qun Li, Yong Tang, Wen Chen, Zhe Yang, Mu Xin Zhao, Wei Xin Wang, Li Si Xu, Jun Feng
Resurfacing large facial defect is a continuing challenge for plastic surgeons. Skin graft or free flap is hard to obtain satisfactory results or is beyond the skill of most surgeons. The authors performed 13 expended submental island flaps to resurface middle and lower facial defects and achieved satisfactory results. In the first stage operation, the authors implanted one soft tissue expander in the anterior neck region which was expanded over an average of 3 months. In the second stage operation, the authors elevated the expanded submental island flap to resurface facial defect...
October 14, 2016: Journal of Craniofacial Surgery
Wei-Liang Chen, Zhao-Hui Yang, Zhi-Quan Huang, Song Fan, Da-Ming Zhang, You-Yuan Wang
PURPOSE: Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. PATIENTS AND METHODS: This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction...
September 13, 2016: Journal of Oral and Maxillofacial Surgery
Andrew Cho, Francis T Hall
PURPOSE OF REVIEW: Perforator flaps are increasingly being used to reconstruct head and neck defects. They offer several advantages over nonperforator-based flaps with lower donor site morbidity and a versatile range of reconstructive options. The anterolateral thigh flap is well established in the head and neck and is a good example of a reliable perforator free flap. With the increasing use of both free and regional perforator-based flaps, it is timely to review their anatomy, clinical applications, and role in head and neck reconstruction...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Robert Lukavsky, Gary Linkov, Christopher Fundakowski
Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers...
July 2016: Archives of Plastic Surgery
Nathan Jowett, Tessa A Hadlock, Eyal Sela, Miklos Toth, Rainald Knecht, Balazs B Lörincz
OBJECTIVE: To objectively assess donor site morbidity after harvesting the facial artery musculomucosal flap. Use of the FAMM-flap in oral cavity reconstruction remains sporadic. This case series describes our newly developed standardized assessment of this flap in a floor of mouth (FOM) reconstructive setting. METHODS: Standardized postoperative assessment of the FAMM flap for donor site wound complications, functional, facial mimetic and oncologic outcomes. RESULTS: There were no wound complications...
July 21, 2016: Auris, Nasus, Larynx
Damian Mullan, Damir Kosutic
BACKGROUND AND OBJECTIVES: Vascularized submental lymph-node (VSLN) transfer is gaining popularity as a reliable donor-site in microsurgical treatment of lymphedema. However, variations in number, location, and blood supply to submental lymph-nodes as well as associate skin-paddle make a predictable flap harvest a challenging task. We analyzed this region on preoperative imaging, to improve accuracy of VSLN transfers. METHODS: Contrast CT-scan analysis of VSLN-flap areas was performed in 58 patients...
July 8, 2016: Journal of Surgical Oncology
Neerav Goyal, Nathan Jowett, Sunshine Dwojak, Mary Beth Cunane, David Zander, Tessa A Hadlock, Kevin S Emerick
BACKGROUND: Free muscle transfer is an important in dynamic facial reanimation; however, suitable donor vessels in this population can be inadequate. In this case series, the submental vessels were used as donors to free gracilis muscle in vessel-depleted patients. METHODS: Five patients underwent free gracilis muscle transfer for smile reanimation, 2 with a prior failed free gracilis transfer, 2 with vascular anomalies, and 1 with previous distal ligation of the facial vessels...
October 2016: Head & Neck
Chieh-Han J Tzou, Stefan Meng, Tinhofer Ines, Lukas Reissig, Ursula Pichler, Johannes Steinbacher, Igor Pona, Julia Roka-Palkovits, Thomas Rath, Wolfgang J Weninger, Ming-Huei Cheng
BACKGROUND: Harvesting the submental flap for vascularized lymph node transfer (VLNT) presents a challenging procedure because of, the topographic variation of the submental artery (SA) and the marginal mandible nerve (MMN) and the limited pedicle length for a free tissue transfer. The aim of this study was to evaluate surgical anatomical landmarks and variations of the submental lymph node flap (SLNF). METHODS AND MATERIALS: The authors examined the characteristics and landmarks of 18 SLNF in nine fresh cadavers...
June 23, 2016: Journal of Surgical Oncology
Matthew J Zdilla, Alex R Pancake, H Wayne Lambert
The anterior belly of the digastric muscle (ABDM) is important in a variety of surgeries including submental lipectomy, rhytidectomy, alteration of the cervicomental angle via muscle resection, the "digastric corset" procedure for submental rejuvenation, the submental artery flap, and reanimation of the mouth after facial nerve palsy. Despite its clinical significance, little information exists regarding the morphometrics of the ABDM or its associated intermediate tendon. This study analyzed a total of 35 intact ABDMs and 43 intact intermediate tendons from 23 cadavers...
July 2016: Journal of Craniofacial Surgery
Fabrizio Schonauer, Annalena Di Martino, Gisella Nele, Mariangela Santoro, Giovanni Dell'Aversana Orabona, Luigi Califano
Oral and oropharyngeal squamous cell carcinoma (Scc) occur most commonly in middle-aged and elderly individuals. Free flaps are commonly used for reconstruction of extensive tumor resection defects in the oral cavity. Age alone is not an independent variable for increased risk in microvascular reconstruction; however operative time and ASA risk score correlated with medical complications but not with surgical complications. The submental island flap has proven to be a reliable alternative in reconstruction of composite oral cavity defects for its thinness, pliability and versatility in design, shared by the radial forearm free flap, and its advantageous donor site...
September 2016: International Journal of Surgery
Aravind Ramkumar
Submental Artery Flap (SMAF) was first described in 1990 and has gained popularity ever since. However there has been relative paucity on information about the use of this flap in irradiated patients. Our aim was to explore the success of SMAF for reconstructing defects following oral cancer resection in this group of patients After prior approval from scientific and ethical committee, we performed a retrospective review of records of eleven patients who underwent SMAF reconstruction between March 2009 and September 2012...
September 2015: Indian Journal of Surgical Oncology
Özay Özkaya Mutlu, Tuğçe Yasak, Onur Egemen, Turgut Kayadibi, Kadir Tasasiz
PURPOSE: For reconstruction of intraoral and lower face defects, it is important to use flaps that prevent reliable and pliable soft tissue and it is possible to use aesthetically most compatible with recipient site. In this study, the authors aimed to present their clinical experiences and results of lower face and intraoral defects reconstructions with submental artery island perforator flap without including the digastric muscle to have a thinner and useful flap. METHODS: Six patients with lower face and intraoral defects that were reconstructed using the submental artery island flap between November 2013 and February 2015 were retrospectively analyzed...
June 2016: Journal of Craniofacial Surgery
Zao Fang, Zhuowei Tian, Chenping Zhang, Jian Sun, Jingzhou Hu, Yue He
PURPOSE: To determine risk factors for pedicle flap complications in elderly patients undergoing oral and maxillofacial reconstruction. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study and enrolled a sample of patients at least 75 years old who underwent resection of oral and maxillofacial tumors and pedicle flap reconstruction from January 2004 through December 2013. The primary predictor variable was reconstructive technique grouped into 5 types of pedicle flap...
October 2016: Journal of Oral and Maxillofacial Surgery
Yuxing Guo, Chi Mao
Total lower lip reconstruction was performed in a 72-year-old man following a squamous cell carcinoma resection. To obtain an optimal functional result and to avoid any additional facial scarring, a submental island flap was used in a one-stage procedure. After 2.5 years of follow-up, the patient is very satisfied with the shape and function of the lower lip.
April 2016: Facial Plastic Surgery: FPS
Brittany E Howard, Thomas H Nagel, David M Barrs, Carrlene B Donald, Richard E Hayden
OBJECTIVES: To compare reconstructive techniques, operative times, duration of hospitalization, and need for subsequent flap revisions between reconstructive approaches to lateral skull base defects. STUDY DESIGN: Case series with chart review. SETTING: Tertiary academic referral center. SUBJECTS: Patients (n = 31) undergoing reconstruction of composite lateral skull base defects from 2002 to 2014. METHODS: Data were analyzed for demographics, tumor characteristics, reconstructive technique, operative time, duration of hospitalization, complications, and outcomes...
June 2016: Otolaryngology—Head and Neck Surgery
C Ricour, J Ferri, G Thiery, C Fontaine, G Raoul
INTRODUCTION: Submental flap is useful for intra-oral reconstructions and reconstructions of the lower two thirds of the face. Dissection is delicate because of a difficult exposure under the lower rim of the mandible, numerous collateral arterial branches and the proximity of the marginal branch of the facial nerve. The aim of our work was to propose anatomical landmarks in order to facilitate the submental flap raising. MATERIAL AND METHOD: Ten bodies preserved in Biomet liquid were dissected bilaterally...
April 2016: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
D Forner, T Phillips, M Rigby, R Hart, M Taylor, J Trites
BACKGROUND: In Canada, 4,400 cases of oral cancer are diagnosed yearly. Surgical resection is a key component of treatment in many of these cancers. Reconstruction of defects, with the goal of preserving function, is of utmost importance. Several choices are possible for reconstruction of larger defects, including both free and pedicled flaps. Free flap reconstruction is reliable and effective, but requires additional personnel and peri-operative resources. Pedicled flaps remain an important alternative to free flaps, and are less resource intensive...
2016: Journal of Otolaryngology—Head & Neck Surgery
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