Biography
Biography: Theodore Dickinson Klug
Abstract
Introduction:
With oral cavity cancer being the sixth most common cancer worldwide, comprising 30% of all H&N cancers, the submental flap emerged over the past decade as a purported, easier way to fix oral cavity defects. Often defined as a simple method for reconstructing small to moderate size oral cavity defects, the submental flap has continued to gain in populairty. Reported as reliable and rapid to harvest, especially relative to the more common free flap, the submental flap, however, is not foolproof. Despite the purported reduction in operating time and ability to circumvent sophisticated microsurgical techniques required during pedicle division and reconnection during a free flap, the submental flap can still have complications.
Objectives:
This study seeks to analyze and explain the various post-op complications surrounding submental flaps. This study will estimate the potential impact submental flaps may have relative to the traditional method of using free flap reconstruction, once post-op complications are taken into consideration. It will also serve as a warning to new surgeons who consider using a submental flap, as opposed to the more traditional free flap.
Methods:
Retrospective chart review of 9 patients who underwent submental flaps that subsequently failed.
Results:
9 patients underwent submental flaps to correct an array of oral defects. The defects included: composite resection of right floor of mouth, right ventral tongue partial glossectomy, and right marginal mandibulectomy; parotid defect; floor of mouth (FOM), ventral tongue; tongue, (retromolar trigone)RMT; FOM; partial glossectomy; buccal mucosa; ventral tongue, FOM; FOM. After performing submental flaps on all 9 patients, each flap failed, respectively. Reasons for failure ranged from flap congestion and need for debulking to aberrant blood supply and faulty, local vascular circulation.
Conclusions:
Despite their promising potential and numerous cases with positive outcomes, submental flaps still have the potential to fail. In the hands of a young and inexperienced surgeon, the likelihood of flap failure increases even more.