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Submental flap harvesting

Igor Poccia, Chia-Yu Lin, Ming-Huei Cheng
BACKGROUND AND OBJECTIVES: Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment. Despite these advantages, flap harvest requires resection of platysma, which may cause a marginal mandibular nerve pseudo-paralysis. The aim of this study was to investigate the donor site morbidity of an innovative platysma-sparing vascularized submental lymph node flap transfer for treating extremity lymphedema. METHODS: Ten patients undergoing platysma sparing submental lymph-node flap harvest were prospectively enrolled in the study and compared with a control group of 10 patients who underwent standard submental lymph-node flap harvest...
January 2017: Journal of Surgical Oncology
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
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...
April 2017: 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...
January 2017: Journal of Surgical Oncology
Chieh Han 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...
January 2017: Journal of Surgical Oncology
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
Pearlie W W Tan, Terence Goh, Hideaki Nonomura, Bien-Keem Tan
OBJECTIVES: Vascularized lymph node transfer for lymphedema is an emerging method of treatment. Vascularized lymph nodes have been harvested from a number of donor sites, that is, groin, axilla, and neck. There is a concern that harvesting nodes from the groin and axilla may lead to donor site lymphedema. This risk is greatly reduced in harvesting from the neck due to the abundant supply of lymph nodes here. In this cadaver study, we describe the submandibular and upper jugular groups of lymph nodes, demonstrate their hilar vessels, their source pedicles and drainage veins, quantified and qualified these groups of lymph nodes and their relationship to surrounding structures...
January 2016: Annals of Plastic Surgery
Islam A Elzahaby, Sameh Roshdy, Fayez Shahatto, Osama Hussein
BACKGROUND: Squamous cell carcinoma (SCC) is a fairly common tumor of the oral cavity. This tumor may affect any part of the mucosa of the oral cavity especially the tongue, the floor of the mouth and lips. The encountered intra-oral defects after tumor resection are often large and require climbing up the reconstruction ladder to more complex reconstructive options for accepted functional and cosmetic results to be achieved. However, most of the patients are old with medical co-morbidities requiring fast, simple, less morbid reconstructive option such as local flaps...
July 14, 2015: BMC Oral Health
Weiming Shen, Jie Cui, Jianbing Chen, Jijun Zou
Scar and defect in the lower face always lead to serious facial deformity and asymmetry. Conventional method such as skin graft or free flap is hard to obtain a satisfactory outcome. In this article, we present a skin expanding technique. An expanded flap was designed to repair the lower face scar or defect on submental and submandibular regions. A tissue expander was implanted into the region and inflated for 2 to 3 months. After removing the expander, we harvested the flap as a rotation flap to repair the lower facial defect...
March 2015: Journal of Craniofacial Surgery
Wan-Chun Tsai, Jinn-Moon Yang, Shao-Cheng Liu, Yueng-Hsiang Chu, Wen-Sen Lai, Yaoh-Shiang Lin, Jih-Chin Lee
Head and neck surgeries often accompany with moderate-sized defects that require time-consuming reconstructions by free flaps. The submental flap is a versatile and time-effective option for reconstruction of orofacial defects providing acceptable cosmetic and functional results without requiring microsurgical techniques. A retrospective case series study of patients who underwent reconstruction with the submental flap between 2009 and 2013 was conducted. There were 36 patients (33 men and 3 women), with a mean age of 56...
December 2015: European Archives of Oto-rhino-laryngology
Jawad Safdar, Fa-Yu Liu, Yousuf Moosa, Zhong-Fei Xu, Zhen-Ning Li, Chang-Fu Sun
OBJECTIVE: To compare the platysma flap with submental flap in terms of tumor and flap characteristics, operative properties and the functional outcomes. METHODS: A total of 65 patients presented with tumors of head and neck and underwent curative tumor resection with different neck dissections at the Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology of China Medical University; from March 2005 to December 2012 were included in the study...
July 2014: Pakistan Journal of Medical Sciences Quarterly
Allen Cheng, Tuan Bui
The submental island flap is a local flap that is simple to raise and is useful for oral and lower face reconstruction of soft tissue defects. It is based on the submental artery and the facial vein. Using a retrograde flow design allows for reconstruction of forehead, temporal, and periorbital defects. Raising the flap with the ipsilateral digastric and a portion of the mylohyoid muscle is helpful in protecting the vascular pedicle. Extra care is required when raising the flap when performing an elective or therapeutic neck dissection, because Level I lymph-node-bearing tissue may be harvested with the flap...
August 2014: Oral and Maxillofacial Surgery Clinics of North America
Hanqian Liu, Huiming Yu, Jiawu Liu
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)...
September 2013: Chinese Journal of Reparative and Reconstructive Surgery
Fa-yu Liu, Rui-wu Li, Jawad Safdar, Zhen-ning Li, Nan Guo, Zhong-fei Xu, Shu-fen Ge, Jun-lin Li, Shao-hui Huang, Xue-xin Tan, Chang-fu Sun
BACKGROUND: The usage of submental flap is a good method for head and neck reconstruction, but it has some risk also, such as anatomical variations and surgical errors. In this article, we present a modified incision design for the submental flap. METHODS: We designed a modified submental flap incision method based on the overlap of the incision outline of the submental flap, platysma myocutaneous flap and infrahyoid myocutaneous flap. If we found that the submental flap was unreliable during the neck dissection at the level III, II and Ib areas, the infrahyoid myocutaneous flap or platysma myocutaneous flap was used to replace it...
2013: PloS One
Richard E Hayden, Thomas H Nagel, Carrlene B Donald
OBJECTIVES/HYPOTHESIS: Evaluate feasibility and success of elongating only the venous pedicle of the submental flap to increase the superior arc of rotation for the "hybrid" flap allowing coverage of more distal defects. STUDY DESIGN: Retrospective evaluation of all submental flaps undergoing pedicle-lengthening procedure at a single institution. METHODS: Medical records were reviewed for all patients undergoing reconstruction with submental flaps between 2002 and 2012...
March 2014: Laryngoscope
Jih-Chin Lee, Wen-Sen Lai, Chuan-Hsiang Kao, Chiang-Hung Hsu, Yueng-Hsiang Chu, Yaoh-Shiang Lin
PURPOSE: The objective of this study was to implement a scoring system to analyze the authors' experience of donor-site morbidity after harvesting a submental flap for the reconstruction of surgical defects at the head and neck region after oncologic resection. MATERIALS AND METHODS: A retrospective case series study was conducted of patients who underwent reconstruction with a submental flap at the Tri-Service General Hospital (Taipei, Taiwan) from 2008 through 2012...
October 2013: Journal of Oral and Maxillofacial Surgery
D Xuwei, X Jian, L Xueqin, Z Xianjie, Y Jianbo, L Wei, M Ligen
OBJECTIVE: The aim of our report is to evaluate the outcomes of the submental island flap reconstruction for defects after ablation in patients with head and neck cancer. METHODS: All patients who underwent reconstruction for head and neck defects with the submental island flap at the Cancer Center for Guangxi Medical University between January 2008 and May 2012 were observed. The site of the tumour, the clinical stage, the technique of flap harvesting, the outcome of cosmesis and function were recorded...
2013: Head & Neck Oncology
Bernardo Bianchi, Andrea Ferri, Silvano Ferrari, Chiara Copelli, Teore Ferri, Enrico Sesenna
The iliac crest free flap is one of the most reliable flaps for maxillary reconstruction because of the large amount of bone provided and the chance to harvest both muscle and skin. However, reconstruction of maxillary through-and-through defects requires special skills to be managed. Simultaneous replacement of oral lining and external tissue with the same features as the resected skin is difficult to achieve with conventional techniques and the use of flaps association is often necessary to ensure acceptable cosmetic and functional results...
December 2013: Journal of Plastic Surgery and Hand Surgery
Seong-Ho Jeong, Byung-il Lee
To obtain optimum aesthetic result, perioral soft tissue defects require reconstruction using similar tissue. The submental area has very similar characteristics to perioral soft tissue and consists of thin, pliable tissue with a perfect color match. Therefore, we have used submental tissues for reconstruction of perioral soft tissue defects and application of the techniques, and results are discussed in this article. Between February 2001 and April 2008, 14 perioral soft tissue reconstruction procedures using the submental tissues were performed...
May 2012: Journal of Craniofacial Surgery
Ayman A Amin, Mostafa A Sakkary, Ashraf A Khalil, Mohammmed A Rifaat, Sherif B Zayed
BACKGROUND AND PURPOSE: The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. However, its role in composite defects involving the jaw is not clearly defined. Indeed, controversy exists about the flap's interference with an oncologically sound neck dissection PATIENTS AND METHODS: A total of 21 patients with oral cavity cancers over a three year period were included. All patients underwent surgical resection and immediate reconstruction with submental flap except one patient who had delayed reconstruction with reversed flap...
2011: Head & Neck Oncology
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