The application of submental island flap in head and neck surgery

Objective: This article discusses the anatomy, surgical procedure,indication, advantages and disadvantages of the submental island flap in reconstruction of the defects after head and neck tumor surgery, based on our clinical experience.

Methods: The submental island flap was transferred with the submental vessels(A/V) as pedicle. In harvesting the flap, the flap was raised commencing from the contralateral side, dissecting all tissues off the mylohyoid muscles. Submandibular triangle dissection was taken until the facial artery and the facial vein. Then the submandibular gland and submandibular nodes were removed and submental vessels were left. This produces a large skin paddle which can be tunnelled to its recipient site.

Results: From Aug. 1998 to Oct. 1999, 16 submental island flaps were performed in our department. 15 flaps survived well and 1 flap failed, with a success rate of 15/16 (93.8%).

Conclusions: The submental island flap is appropriate for primary reconstruction of the defect after various head and neck tumor surgery. It has a long and reliable pedicle, rapid and simple to raise and free from vessel anastomosis. It leaves a well hidden donor site. However, it can't be applied to these cases whose donor site had been radiated before surgery and whose submental and submandibular triangles lymph nodes were positive.