The submental island artery flap has become increasingly popular since its introduction by martin et al in 1993. The use of submental island flap for total lower lip reconstruction. It is rare and occurs mainly in children that land is weakened by malnutrition. Pdf nasolabial flap reconstruction of floor of mouth. Localregional flaps in oralhead and neck reconstruction. The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. Applied anatomy of the submental island flap and its. When the submental artery turns upward over the border of the mandible it divides into a superficial and a deep branch. The hybrid submental flap for tongue reconstruction todd c.
The supraclavicular artery island flap in head and neck. Click download or read online button to get atlas of regional and free flaps for head and neck reconstruction book now. Combined submentaltongue flap for reconstruction of. Isbn 9781118340332 local and regional flaps in head neck reconstruction. The nasolabial flap was rotated medially for reconstruction of the upper lip and then folded upon itself to form the inner and outer aspects of the upper lip. Original article the submental island flap in lingual. Consequently, this article presents our experience of this flap in reconstruction of lingual defects with the anatomy, surgical technique, advantage. This site is like a library, use search box in the. Table 2 shows various modifications of this flap 710.
This report therefore extends current knowledge of the variations of the vascular anatomy of the head and neck. The submental artery island flap sif is an axial fasciocutaneous flap that includes skin, subcutaneous tissue, platysma, and fat and is pedicled on the submental artery and veins figures 1, 2. 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. Submental artery island flap in reconstruction of hard.
Reconstruction of intraoral soft tissue defects is important in restoring function and esthetic. Files with an owner password can be unlocked instantly. The submental island flap for palatal reconstruction. Reconstruction of an inferior orbital rim and cheek defect. The submental island flap is supplied by the submental artery, a branch of the facial artery. Summary the submental island flap is a reliable and versatile flap for head and neck reconstruction. Pdf the submental island flap for palatal reconstruction. Mean operative time and duration of hospital stay were significantly shorter in the submental island flap group. Surgeons can use the skin and vessels in reconstruction of the face or the oral cavity.
Locally advanced head and neck cancer often requires wide resections of the cheek and parotid gland, and in an ageing population preferred reconstructive options aim to avoid lengthy operating times or high risk surgery. Ideal for oral and maxillofacial surgeons, facial plastic. The skin territory of the single pedicle submental island flap is as large as 7. Submental artery island flap smif has gained acceptance as a simple and reliable option in oral reconstruction. The submental flap has rekindled interest in using cervical flaps for reconstruction of head and neck defects. How to split a pdf file adobe acrobat dc tutorials adobe support. Submental flap for soft tissue reconstruction following.
The flap is drained through submental vein into the facial vein. It arises deep to the submandibular gland and may be deep 70% or superficial 30% ref 8a to the digastric muscle. 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 submental island flap sif is a pedicled flap based upon the submental artery and vein. Submental island flap versus radial forearm free flap for.
The submental island flap was harvested figure 5, based on the submental branch of the ipsilateral side and after completion of the neck dissection, starting. Click download or read online button to get local and regional flaps in head and neck reconstruction book now. Atlas of regional and free flaps for head and neck. The use of submental island flap for total lower lip.
Conclusion the submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and. The contemporary dictum in head and neck reconstruction is to utilize microvascular transfer techniques. However, there are unsettled concerns regarding its safety in oral cancer because of insufficient data in the literature. In the radial forearm free flap group, partial skin graft loss and arm function restriction were recorded. However, its role in composite defects involving the jaw is not clearly defined. View the article pdf and any associated supplements and figures for a period of 48 hours. Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa. Hair bearing nature of this flap in men makes it less appropriate. Blood supply of this flap can be retrograded based on facial artery or reverse flow based on angular artery 4,5. In the submental island flap group, all the flaps were successfully transferred with no donor site complications. The hybrid submental flap for tongue reconstruction.
Regional flaps suitable for skin replacement in this special situation with deep cheek burn are cervical flaps. The first patient was a 75yearold man with mucoepidermoid carcinoma in the leftside floor of the mouth. The submental island flap is a viable reconstructive. Island flaps are raised with a base consisting solely of a fully mobilized vascular pedicle, and they may include fascia, subcutaneous tissue, skin, and segments of vascularized muscle, bone, tendon, and cutaneous nerves, depending on the particular reconstructive needs.
Local and regional flaps in head and neck reconstruction. Background the purpose of this study was to present the feasibility of reconstructing an inferior orbital rim and cheek defect with a pedicled osteomyocutaneous submental flap. Reconstruction of hypopharyngeal defects with submental. The site of the tumour, the clinical stage, the technique of flap harvesting, the outcome of cosmesis and function were recorded. A total of eight patients were operated with this technique. In this article, the authors present their experience of using this flap for hypopharyngeal defects after laryngopharyngectomy. We report a case of mandibular sequela noma requiring plastic surgery.
A case report yuxing guo, md 1 chi mao, md1 1department of oral and maxillofacial surgery, peking university school and hospital of stomatology, beijing, china facial plast surg 2016. Pdf applied anatomy of the submental island flap and its. Oncological safety of submental artery island flap in oral. Submental artery island flap was first described by martin et al. Submental artery island flap vula university of cape town. Submental flap is an axial pattern skin flap akin to a perforator based flap in the extremity, with a wide arc. Method a 77yearold women with a right nasosinusal adenoid cystic carcinoma invading soft tissues and skin of the cheek, the inferior rim of the orbit, the hard palate, and the middle turbinate is presented. We collected wet specimens of fresh cadaveric heads from the han chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps. Noma is a severe and mutilating gangrenous stomatitis of the orofacial sphere, starting on periodontal side. Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa, retromolar trigone, parotidectomy defects, and tongue. Pdf applied anatomy of the submental island flap and its clinical application in the repair of defects following hypopharyngeal carcinoma resection pdf objective to explore the feasibility of. Extended indications and technical refinements ayman a amin1, mostafa a sakkary1, ashraf a khalil2, mohammmed a rifaat1 and sherif b zayed1 abstract background and purpose. With acrobat reader dc, you can do more than just open and view pdf files. The submental island flap in lingual cancer reconstruction.
The use of axial based superficial temporal artery. Address for correspondencechi mao, md, department of oral and. However, if the file is thoroughly encrypted, you can only unlock the file by. Original article submental myocutaneous island flap in the reconstruction of facial defects. Submental island pedicled flap vs radial forearm free flap. The use of a submental artery island flap is a relatively new and an increasingly popular option for head and neck reconstruction that provides an additional reconstructive option. Pedicled flap in lingual cancer reconstruction 14377 int j clin exp med 2016. More and more, the use of local or regional flaps has been relegated to the use in the salvage setting of failed microvascular flaps or in patients deemed too sick to undergo long anesthetics as is required for free flap transfers.
The submental island flap for reconstruction of temporal. Ideal for oral and maxillofacial surgeons, facial plastic surgeons, and head and neck surgeons, the book serves as a useful guide to planning reconstructive cases and an easily accessible reference prior to operation. The supraclavicular artery island sai flap is a local fasciocutaneous flap taken from skin on the shoulder and supraclavicular area that is gaining popularity for. The second patient was a 74yearold man with recurrent acinic cell carcinoma in the anterior oral floor. The submental flap is gaining popularity as a simple technique for reconstruction of. The submental island flap in head and neck reconstruction. Therefore, deepithelialized variant is introduced to overcome the problem of hair with this. A practical approach provides comprehensive, stepbystep instruction for flap raising and insetting for the head and neck region. This was a 7yearold patient with moderate acute malnutrition. This is a retrospective study of six patients who underwent hypopharyngeal defect reconstruction with submental flap from 2008 to 2011, operated.
Rich vascular supply comes from subcutaneous muscular pedicle. We treated two patients requiring nasolabial flap reconstruction. The submental vessels also supply a territory of skin in the submental area. Unlimited viewing of the article pdf and any associated supplements and figures. A slender sta flap with 3 skin islands was designed according to preoperative. Its easy to add annotations to documents using a complete set of commenting. Research open access the submental flap for oral cavity reconstruction. Submental artery island flap in reconstruction of hard palate after wide surgical resection of verruccous carcinoma, two case reports amin rahpeyma1,saeedeh khajehahmadi2, mohammadreza nakhaei2 abstract introduction.
Read a case of upper lip and moustache reconstruction using a submental artery perforator smap flap, european journal of plastic surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. To analyse the the oncological safety of smifin oral reconstruction and to study the. Submental myocutaneous island flap in the reconstruction. The pectoralis major flap is an axial flap and is based primarily on the pectoral branch of the thoracoacromial artery and the thoracoacromial artery is a branch of the axillary artery, itself a continuation of the subclavian artery. Island flap in reconstruction of full thickness extensive lateral. Pdf the cervicosubmental keystone island flap for locoregional head and neck reconstruction andrew sizeland academia. Submental artery island flap can be used as a pedicle or free flap. Submental artery islandsubmental artery island flapflap department of oral and maxillofacial surgery vinnitsa national medical university presentation by, patrick royson albertina sheehama supervised by. We found that the average length and width of the submental island. Divided and sliding superficial temporal artery flap for primary. Indeed, controversy exists about the flap s interference with an oncologically sound neck dissection a total of 21 patients with oral cavity cancers over a three year period were. Its minimal donor site morbidity, excellent cosmetic match. The submental artery island flap is a simple and reliable option for oral cancer reconstruction in carefully selected cases, with acceptable cosmetic and functional results and reasonable. Reconstruction of the lip commissure with upper and lower.
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