ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

What Is the Oncologic Safety of Using the Submental Flap to Reconstruct Oral Cavity Cancer Defects?

by Brent A. Chang, MD, Ameya A. Asarkar, MD, and Cherie-Ann O. Nathan, MD • December 9, 2019

  • Tweet
  • Email
Print-Friendly Version

TRIO Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.

You Might Also Like

No related posts.

Explore This Issue
December 2019

Background

The submental flap has gained significant popularity for head and neck reconstruction in the past few decades. This flap is generally used as a pedicled flap and provides thin, pliable tissue of substantial size, making it ideal for reconstructing oral cavity cancer defects. Using a pedicled flap instead of a free flap has the benefit of decreasing operative time, length of hospital stay, need for intensive monitoring, and overall costs. However, the oncologic safety of using the submental flap for oral cavity cancer reconstruction has been controversial. The blood supply to the submental flap arises from the facial vessels in level I of the neck, which is a first-echelon lymphatic drainage basin for oral cavity malignancies. Some surgeons would argue that the submental vessels can be safely skeletonized while still achieving adequate oncologic clearance of lymphatic tissue. Other surgeons have advocated against submental flap reconstruction for oral cancer given the concern for increased risk of locoregional recurrence due to inadequate lymph node dissection or transplantation of malignant cells into the site of reconstruction.

Best Practice

It is oncologically safe to use the submental flap for reconstruction of oral cavity cancer defects. The surgeon must feel comfortable dissecting and preserving the submental vasculature while still achieving an oncologic resection of the level I lymphatic tissue. An adequate lymph node dissection of level I, at the minimum, should be performed even in the N0 neck. In the setting of the N+ neck, limited quality data support that the submental flap can be done with reasonable oncologic safety in very carefully selected patients; however, these data are at risk of selection bias, as N+ patients who could not undergo submental flap reconstruction were likely excluded. Thus, the surgeon should still proceed with caution and should strongly consider having a backup reconstructive option available (Laryngoscope. 2019;129:2443–2444).

Filed Under: Head and Neck, TRIO Best Practices Tagged With: oral cavity cancer, submental flapIssue: December 2019

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Complications for When Physicians Change a Maiden Name
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • How To: A Modified Endoscopic Draf III Approach for Dermoid Cysts
    • How To: Inferior Meatus Augmentation Procedure for Empty Nose Syndrome
    • Otolaryngology Resident Says Art Helps Her Process Ideas on Wellness, Burnout
    • Age-Related Hearing Loss Is Associated with Incident Dementia in Adults Over 60
    • COVID-19 Associated with Upsurge in Otolaryngology Publications

Polls

Do you think training primary care doctors through otolaryngology fellowships will help curb the influx of unnecessary visits to specialists?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2022 The Triological Society. All Rights Reserved.
ISSN 1559-4939