Submental island flap for oropharyngeal reconstruction: UK experience of 25 cases

Since the first description of the submental island flap 24 years ago, advances in techniques have expanded the indications for its use and improved its characteristics to make it a favourable reconstructive option for orofacial oncological defects. We describe our experience (particularly perioperatively) of its use, the complications, and the precautions adopted. We retrospectively reviewed the cases of 25 patients and focused on the operating time, use of tracheostomy, duration of postoperative inpatient stay, oropharyngeal function, and associated morbidities. Eighteen patients had defects of the tongue. Other defects were retromolar (n=2), buccal (n=1), mandibular (n=2), and maxillary (n=2). The mean (range) operating time was 250 (152-370) minutes and the mean (range) postoperative stay was 11 (4-16) days. Only four patients required a tracheostomy, and four required postoperative monitoring in the intensive care unit (ICU). The complications were partial flap loss (n=6), sialocele (n=1), and seroma (n=1). The flap has shown its merit as an option for oral reconstruction because of its reliability, versatility, and relative ease of application. To our knowledge, our case series is the largest in the United Kingdom, and we hope that in future, this humble flap will be a standard reconstructive option for small to medium oral resection defects.