The reconstruction of head and neck defects with the submental island flap

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. Unlike the experience of other colleagues, for patients with tongue and mouth floor cancers, we developed some special operative techniques for reconstruction of defects. Results There were 12 men and 6 women, with ages ranging from 34 to 77 years (mean ± SD of 55.17 years). The sites of tumour were the tongue, hard palate, soft palate, mouth floor, face, gingival, maxillary sinus and buccal mucosa. The sizes of the flaps ranged from 4 × 3 cm to 10 × 7 cm, with a median of 5.6 × 4.2 cm. Seven patients underwent radiotherapy after the surgery; the radiation dose ranged from 23.5 to 60 Gy. The follow-up period ranged from 1 to 50 months, with a median of 20.3 months. The long-term cosmesis and functions were perfect in most patients. Five patients died of metastasis and one patient died of acute coronary syndrome. Conclusions The submental island flap is a reliable alternative for reconstruction of head and neck defects in cancer patients. For colossal defects in the mouth floor, the submental island flap should involve with the submandibular gland, anterior belly of digastric muscle and mylohyoid muscle.