Reconstruction of full-thickness chick defects formed after tumor removal using a modified technique for submental flap dissection

Abstract

Reconstruction of vast penetrating defects after radical resection of advanced tumors of the head and neck is a complex problem of recon structive oral and maxillofacial surgery . In case of a vast full-thickness defect of the chick, it is necessary to create isolated w alls both inside and outside the oral cavit y , i.e. to perform t w o-layer reconstruction. In most articles, use of 2 distant flaps or a double folded free revascular ized autologous transplant are described. Howeve r , performance of such large-scale and long surgical interventions can be limited by pa tient’s age or functional status, as well as other objective factors. In reconstruction of full-thickness chick defects, a submental flap is an adequate alternative to a free revascularized autologous transplant. This surgery is technically much easier and produces a better esthetic effect compared to the use of a combination of temporal myofacial and cervicofacial flaps, as well as a double cervicopectoral flap. The proposed modification of the method – sialoadenectomy at the stage prior to harvesting of the pedicle flap – not only makes dissection easier but allows to determine tumor advancement. Temporal ligation of the facial artery above the branching site of the submental artery reduces blood loss during removal of a primary tumor of the chick.