Submental flap for reconstructing tongue defect with V-Y advancement flap for repairing submental defect

Abstract

Objective To assess the reliability of the facial-submental artery island flap for reconstructing tongue defects and the aesthetic benefits of using two V-Y islanded flaps for repairing the resulting submental defect. Study Design Case series with chart review. Setting Patient with tongue cancer, younger patient, cosmetic outcome. Subjects and Methods Thirty-three tongue defects were repaired with facial-submental artery island flaps, and the submental defects were repaired with two V-Y advancement flaps. The ages of the patients ranged from 28 to 57 years; 19 were men and 14 were women. All of the lesions were tongue squamous cell carcinoma. The size of the facial-submental artery island flap ranged from 3.5 × 7.0 to 5.0 × 8.0 cm. The size of the V-Y advancement flaps ranged from 3.0 × 3.0 to 4.0 × 4.0 cm. Direct closure was achieved at all donor sites. Results The facial-submental artery island flaps and V-Y advancement flaps survived in 93.9 percent and 97.0 percent, respectively. The patients were followed for 12 to 26 months. The functional results in terms of speech and swallowing were good, and the aesthetic outcomes using two V-Y advancement flaps to repair the submental defects were satisfactory. Two patients with extracapsular lymph node spread developed local recurrence: One is alive with disease and the other is dead. Conclusions The facial-submental artery island flap is a simple, reliable flap that is preferred for reconstructing tongue defects. Using two V-Y advancement flaps for repairing the donor site defect improves the cosmetic outcome in the submental region.