Submental Artery Island Flaps (SAIF) for Oral Cavity Cancer: Surgical Technique and Tertiary Care Experience

Naina Kumar; Pranav Mohan Singhal; Bhoopendra Singh Gora; Shubhra Sharma; Kamal Kishor Lakhera; Pinakin Patel; Suresh Singh; Arjun Kumar; Raj Govind Sharma

doi:10.1007/s12070-023-04286-z

Submental Artery Island Flaps (SAIF) for Oral Cavity Cancer: Surgical Technique and Tertiary Care Experience

Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):819-826. doi: 10.1007/s12070-023-04286-z. Epub 2023 Oct 31.

Authors

Naina Kumar¹, Pranav Mohan Singhal¹, Bhoopendra Singh Gora¹, Shubhra Sharma², Kamal Kishor Lakhera¹, Pinakin Patel¹, Suresh Singh¹, Arjun Kumar³, Raj Govind Sharma⁴

Affiliations

¹ Department of Surgical Oncology, SMS Medical College and Attached Group of Hospitals, B 31, Prabhu Marg, Tilak Nagar, Jaipur, 302004 India.
² Department of Surgical Oncology, HCG Cancer Hospital, Jaipur, India.
³ Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India.
⁴ Department of Surgical Oncology, Mahatma Gandhi Medical College and Hospital, Jaipur, India.

PMID: 38440498
PMCID: PMC10908732 (available on 2025-02-01)
DOI: 10.1007/s12070-023-04286-z

Abstract

In oral cancer surgeries, oncological outcomes take precious driverseat. But the copassengers like reconstruction, cosmesis, swallowing and speech outcomes deserve equivalent importance. Submental Artery Island Flaps (SAIF) provide an underutilized and extremely versatile option for reconstruction of defects following early stage oral cavity tumour resections. In this prospective observational analysis, we describe the technique, challenges and outcomes of SAIF at our tertiary care institute. Sixteen patients with Stage I and II oral cavity cancers were enrolled between June 2020 to May 2021. Verrucous carcinomas were five and well differentiated carcinomas were 11 patients. After tumour excision and neck dissections, defects were reconstructed with Pedicled submental flaps. Complications and functional outcomes were analyzed over two years. Nineteen percent were ladies and 81% were gentlemen. Median age was 52 years. Tongue tumours formed majority with 56% cases. Largest skin paddle taken was 36 cm². Flap survival was 88%. There were variations in venous drainage of flaps which have been depicted in case figures. There was no report of orocutaneous fistula. Grade 3-4 speech satisfaction was achieved by 81.2% patients at 6 months. Swallowing was excellent, grade 4-5 for 100% of patients at 6 months. One patient had distant metastasis at 7 months and died. SRLR (Submental flap Recurrences) and trismus were zero percent at two years. The unexplored field of submental flaps can be used for oral cancer reconstructions in a versatile way. Donor site easy closures, no scars on face, early resumption of daily activities and short hospital stay makes it one of the ideal options in early stage oral cavity defects.

Keywords: Oral cancer; Oral cavity defects; Pedicled flaps; Plastic surgery; Submental flap.

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