Hostname: page-component-5cf477f64f-n7lw4 Total loading time: 0 Render date: 2025-04-02T22:30:37.383Z Has data issue: false hasContentIssue false
  • English
  • Français

Submental island flap versus radial forearm free flap for oral tongue reconstruction: a comparison of complications and functional outcomes

Published online by Cambridge University Press:  22 April 2019

P Sittitrai ,
D Reunmakkaew  and
C Srivanitchapoom
P Sittitrai*
Affiliation:
Department of Otolaryngology, Chiang Mai University Hospital, Thailand
D Reunmakkaew
Affiliation:
Department of Otolaryngology, Chiang Mai University Hospital, Thailand
C Srivanitchapoom
Affiliation:
Otolaryngology Unit, Phayao Hospital, Thailand
*
Author for correspondence: Dr Pichit Sittitrai, Department of Otolaryngology, Chiang Mai University Hospital, Chiang Mai 50200, Thailand E-mail: [email protected] Fax: +66 053 935564
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study compared the complications and functional outcomes of patients with oral tongue cancer who had undergone reconstruction using a submental island flap or a radial forearm free flap.

Method

Of the 54 patients, 29 underwent reconstruction with a submental island flap and 25 patients with a radial forearm free flap. The complications and outcomes of speech and swallowing were evaluated.

Results

In the submental island flap group, all the flaps were successfully transferred with no donor site complications. In the radial forearm free flap group, partial skin graft loss and arm function restriction were recorded. Mean operative time and duration of hospital stay were significantly shorter in the submental island flap group. Speech and swallowing function were comparable between the two groups. There was no significant difference in locoregional recurrence between the groups.

Conclusion

The submental island flap is reliable and is suitable for oral tongue reconstruction. It has a lower complication incidence when compared to the radial forearm free flap, while maintaining speech and swallowing function.

Keywords

Surgical FlapsFree Tissue FlapsTongue NeoplasmsSpeechDeglutition
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 5 , May 2019 , pp. 413 - 418
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr P Sittitrai takes responsibility for the integrity of the content of the paper

References

1Kerawala, C, Roques, T, Jeannon, JP, Bisase, B. Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl S2):S83–9Google Scholar
2de Vicente, JC, de Villalaín, L, Torre, A, Peña, I. Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap. J Oral Maxillofac Surg 2008;66:2270–5Google Scholar
3Tarsitano, A, Vietti, MV, Cipriani, R, Marchetti, C. Functional results of microvascular reconstruction after hemiglossectomy: free anterolateral thigh flap versus free forearm flap. Acta Otorhinolaryngol Ital 2013;33:374–9Google Scholar
4Lam, L, Samman, N. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review. Oral Oncol 2013;49:507–24Google Scholar
5Bokhari, WA, Wang, SJ. Tongue reconstruction: recent advances. Curr Opin Otolaryngol Head Neck Surg 2007;15:202–7Google Scholar
6Brown, JS, Rogers, SN, Lowe, D. A comparison of tongue and soft palate squamous cell carcinoma treated by primary surgery in terms of survival and quality of life outcomes. Int J Oral Maxillofac Surg 2006;35:208–14Google Scholar
7Sittitrai, P, Srivanitchapoom, C, Reunmakkaew, D, Yata, K. Submental island flap reconstruction in oral cavity cancer patients with level I lymph node metastasis. Br J Oral Maxillofac Surg 2017;55:251–5Google Scholar
8Martin, D, Pascal, JF, Baudet, J, Mondie, JM, Farhat, JB, Athoum, A et al. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg 1993;92:867–73Google Scholar
9Yanai, C, Kikutani, T, Adachi, M, Thoren, H, Suzuki, M, Iizuka, T. Functional outcome after total and subtotal glossectomy with free flap reconstruction. Head Neck 2008;30:909–18Google Scholar
10Paydarfar, JA, Patel, UA. Submental island pedicled flap vs radial forearm free flap for oral reconstruction: comparison of outcomes. Arch Otolaryngol Head Neck Surg 2011;137:82–7Google Scholar
11Yang, GF, Chen, PJ, Gao, YZ, Liu, XY, Li, J, Jiang, SX et al. Forearm free skin flap transplantation: a report of 56 cases. Br J Plast Surg 1997;50:162–5Google Scholar
12Chow, TL, Chan, TT, Chow, TK, Fung, SC, Lam, SH. Reconstruction with submental flap for aggressive orofacial cancer. Plast Reconstr Surg 2007;120:431–6Google Scholar
13Karmer, FJ, Böhrnsen, F, Moser, N, Schliephake, H. The submental island flap for the treatment of intraoral tumor-related defects: no effect on recurrence rates. Oral Oncol 2015;51:668–73Google Scholar
14Forner, D, Phillips, T, Rigby, M, Schliephake, H. Submental island flap reconstruction reduces cost in oral cancer reconstruction compared to radial forearm free flap reconstruction: a case series and cost analysis. J Otolaryngol Head Neck Surg 2016;45:11Google Scholar
15Parmar, PS, Goldstein, DP. The submental island flap in head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2009;17:263–6Google Scholar
16Howard, BE, Nagel, TH, Donald, CB, Hinni, ML, Hayden, RE. Oncologic safety of the submental flap for reconstruction in oral cavity malignancies. Otolaryngol Head Neck Surg 2014;50:558–62Google Scholar
17Lutz, BS, Wei, FC, Chang, SC, Yang, KH, Chen, IH. Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases. Plast Reconstr Surg 1999;103:132–7Google Scholar
18Camaioni, A, Loreti, A, Damiani, V, Bellioni, M, Passali, FM, Viti, C. Anterolateral thigh cutaneous flap vs. radial forearm free-flap in oral and oropharyngeal reconstruction: an analysis of 48 cases. Acta Otorhinolaryngol Ital 2008;28:7–12Google Scholar
19Hsiao, HT, Leu, YS, Liu, CJ, Tung, KY, Lin, CC. Radial forearm versus anterolateral thigh flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech. J Reconstr Microsurg 2008;24:85–8Google Scholar