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. 2019 Mar 22;4(2):222-226.
doi: 10.1002/lio2.258. eCollection 2019 Apr.

Reconstruction of total parotidectomy defects with a de-epithelialized submental flap

Neerav Goyal  1 , Daniel G Deschler  2 , Kevin S Emerick  2
Affiliations

Reconstruction of total parotidectomy defects with a de-epithelialized submental flap

Neerav Goyal et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: Total parotidectomy yields a large surgical defect that leads to both cosmetic and functional deficits which can be addressed with reconstruction. We evaluated the role of a pedicled submental flap for this reconstruction.

Methods: We reviewed all submental flap reconstructions that were performed for total parotidectomy defects between 2014 and 2016. Data regarding harvest technique, postoperative complications, flap survival, and adjuvant treatment details were recorded. Subjective information regarding retained volume after reconstruction was also obtained.

Results: During the time period, eight patients were identified and in all cases the patients underwent total parotidectomy with facial nerve sacrifice. All patients were discharged within 2 days of hospitalization with no complications or concerns regarding the viability of the flap. All but one patient had radiation therapy. Results with 9.9- to 37.5-month follow-up (mean 22.0 months) show limited volume loss without major contour defect or ear deformity in the follow-up period.

Conclusions: Submental flap reconstruction is a feasible and reliable method for total parotidectomy defect. The inclusion of the mylohyoid muscle aids flap reliability and adds bulk. Inclusion of the dermis helps contour the overlying skin. The flap does not add morbidity or increased complexity intraoperatively or postoperatively.

Level of evidence: 4.

Keywords: Submental flap; pedicled flap; reconstruction; total parotidectomy; volume restoration.

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Figures

Figure 1
Figure 1
Intraoperative photography of submental flap marking (A), elevation (B), inset (C), and closure (D). Postoperative photography demonstrate an oblique (E) and profile (F) view with good contouring and minimal scar deformity.
Figure 2
Figure 2
Postoperative photography demonstrating a portrait (A), oblique (B), and profile (C) view of the scar and reconstructed area noting good contour and minimal scar deformity. Surveillance MRI can also easily distinguish the flap from the underlying wound bed as noted by the white arrow (D).
See this image and copyright information in PMC

References

    1. Loyo M, Gourin CG. Free abdominal fat transfer (FAT) for partial and total parotidectomy defect reconstruction. Laryngoscope May 2016;126(12):2694–2698. - PubMed
    1. Bonanno PC. Re: Dermis‐fat graft after parotidectomy to prevent “Frey's syndrome and the concave deformity.” Ann Plast Surg 1994;33(2):235. - PubMed
    1. Ioannides C, Fossion E. Reconstruction of extensive defects of the parotid region: experience with the pectoralis major and free latissimus dorsi flaps. J Craniomaxillofac Surg 1997;25(2):57–62. - PubMed
    1. Emerick KS, Herr MW, Lin DT, Santos F, Deschler DG. Supraclavicular artery Island flap for reconstruction of complex parotidectomy, lateral skull base, and total auriculectomy defects. JAMA Otolaryngol Head Neck Surg 2014;140(9):861–866. - PubMed
    1. Teknos TN, Nussenbaum B, Bradford CR, Prince ME, El‐Kashlan H, Chepeha DB. Reconstruction of complex parotidectomy defects using the lateral arm free tissue transfer. Otolaryngol Head Neck Surg 2003;129(3):183–191. - PubMed

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