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Submental flap: Game changer in oral cancer reconstruction—A study of 1169 cases
Author(s) -
Pradhan Sultan A.,
Kannan Rajan,
Tiwari Neelesh,
Jain Saurabh,
Khan Sana,
Rodrigues Dale,
Doctor Azmat,
Jatale Raj G.,
Agrawal Kushal,
Shaikh Mohsin
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26125
Subject(s) - medicine , tongue , cheek , surgery , mandible (arthropod mouthpart) , cancer , dentistry , botany , pathology , biology , genus
Background Free‐flap reconstructions (FFRs) are the standard‐of‐care following resections for oral cancer. This study assessed an alternative, the pedicled submental flap (SF) for its versatility, oncological outcomes, and comparative operative time and cost. Methods This was a longitudinal prospective study of 1169 patients of oral cancer reconstructed with the SF. Oncological outcomes in terms of recurrence rate and disease‐free survival (DFS), were analyzed in 730 cases with a minimum of 18 months follow‐up. Surgical time and cost were compared between 20 SFs and 14 FFRs performed consecutively. Results SF was used to reconstruct defects in the cheek (29.2%), mandible (41.6%), tongue (26.3%) and palate (2.7%) with a 94% flap survival. N+ at level 1 did not adversely affect the recurrence rate as compared with N+ at levels other than level 1 (27.52% vs 29.81%). SFs took a shorter time (186 minutes vs 474 minutes) and cost significantly less than FFRs ( P < .0001). Conclusions SF can reconstruct various oral defects, is sturdy, and esthetically and functionally satisfactory. The procedure time is much shorter than for FFR and costs considerably less. With careful case selection and meticulous clearance, SF reconstruction is oncologically safe even in N+ neck.