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. 2013 Jul;3(2):144-7.
doi: 10.4103/2231-0746.119224.

Oral reconstruction with submental flap

Amin Rahpeyma  1 , Saeedeh Khajehahmadi
Affiliations

Oral reconstruction with submental flap

Amin Rahpeyma et al. Ann Maxillofac Surg. 2013 Jul.

Abstract

Background: Submental flap is a useful technique for reconstruction of medium to large oral cavity defects. Hair bearing nature of this flap in men makes it less appropriate. Therefore, deepithelialized variant is introduced to overcome the problem of hair with this flap. Recently, application of this flap has been introduced in maxillofacial trauma patients.

Materials and methods: Deepithelialized orthograde submental flap is used for the reconstruction of oral cavity mucosal defects.

Results: Four cases including two trauma patients and two squamous cell carcinomas (SCCs) of oral cavity were treated using deepithelialized orthograde submental flap. There were no complications in all four patients and secondary epithelialization occurred in raw surface of the flap which was exposed to oral cavity.

Conclusion: Deepithelialized orthograde submental flap is very effective in reconstruction of oral cavity in men. The problem of hair is readily solved using this technique without jeopardizing flap blood supply.

Keywords: Avascular necrosis; papillary squamous cell carcinoma; submental flap.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Orthograde submental flap (Pattle modification) is deepithelialized after flap elevation, (b) Deepithelialization began before flap elevation in patients with tight submental skin (not presented in our series)
Figure 2
Figure 2
Avascular necrosis of the mandibular segment after trauma is managed with simultaneous bone grafting and deepithelialized submental flap (a) Before, (b) Immediately after, and (c) 3 weeks later, (d) Schematic picture of the flap
Figure 3
Figure 3
Vestibuloplasty and bone graft coverage in a maxillofacial trauma patient was performed using deepithelialized submental flap (a) Before, (b) Immediately after, and (c) 3 weeks later
Figure 4
Figure 4
Alveolar ridge and floor of the mouth squamous cell carcinoma with bone invasion (T4) was reconstructed by deepithelialized submental flap (a) Before, (b) Immediately after, and (c) 3 weeks later
Figure 5
Figure 5
Huge papillary squamous cell carcinoma (SCC) of oral cavity and oropharynx reconstructed after resection with deepithelialized submental flap (a) Before, (b) Immediately after, and (c) 3 weeks later
Figure 6
Figure 6
Histologic section of secondary epithelialization in deepithelialized submental flap. Fibrous changes in fat tissue that is covered by thin keratinized squamous epithelium (2 years after operation, H&E staining, original magnification ×40)
See this image and copyright information in PMC

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