Submental Island Flap versus Free Flap Reconstruction for Complex Head and Neck Defects
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Mads Gustaf Jørgensen, MD*, Siavosh Tabatabaeifar, MD*, Navid Mohamadpour Toyserkani, MD, PhD, Jens Ahm Sørensen, MD, PhDFirst Published September 10, 2019 Review Article
https://doi.org/10.1177/0194599819875416
Article information
No Access
Abstract
Objective
Complex soft tissue reconstruction of the head and neck requires a viable, versatile, and dependable flap. Free flaps, such as the radial forearm and anterolateral thigh flap, have been the mainstay of complex head and neck reconstruction. However, a local pedicled flap, such as the submental island flap (SIF), could be a more effective and less demanding alternative. This systematic review and meta-analysis aim to compare free tissue transfer (FTT) with the SIF for head and neck reconstruction.
Data Sources
We performed a systematic search in PubMed and EMBASE databases. Meta-analysis was performed on outcomes reported in ≥3 studies.
Review Methods
Candidate articles were assessed for eligibility by 2 authors. Three authors performed data extraction and methodological quality of the included studies using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies.
Results
The search strategy resulted in 450 studies, of which 7 were included in the analysis, yielding 155 SIF and 198 FTT cases. Operating time and length of stay were significantly lower for the SIF than for FTT (P = .05 and P = .0008). There was no significant difference between the groups for complete flap loss, debulking revisions, and oncologic recurrence.
Conclusion
These results suggest that the SIF reduces length of stay and operating time as compared with FTT in head and neck reconstruction. These findings suggest that the SIF can be considered an alternative reconstructive option to FTT when evaluating intraoral, lateral facial, skull base, and parotidectomy defects, given comparable defect size and tumor biology.
Keywords submental island flap, free flap, complications, oral reconstruction, meta-analysis, systematic review
Show less
Mads Gustaf Jørgensen, MD*, Siavosh Tabatabaeifar, MD*, Navid Mohamadpour Toyserkani, MD, PhD, Jens Ahm Sørensen, MD, PhDFirst Published September 10, 2019 Review Article
https://doi.org/10.1177/0194599819875416
Article information
No Access
Abstract
Objective
Complex soft tissue reconstruction of the head and neck requires a viable, versatile, and dependable flap. Free flaps, such as the radial forearm and anterolateral thigh flap, have been the mainstay of complex head and neck reconstruction. However, a local pedicled flap, such as the submental island flap (SIF), could be a more effective and less demanding alternative. This systematic review and meta-analysis aim to compare free tissue transfer (FTT) with the SIF for head and neck reconstruction.
Data Sources
We performed a systematic search in PubMed and EMBASE databases. Meta-analysis was performed on outcomes reported in ≥3 studies.
Review Methods
Candidate articles were assessed for eligibility by 2 authors. Three authors performed data extraction and methodological quality of the included studies using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies.
Results
The search strategy resulted in 450 studies, of which 7 were included in the analysis, yielding 155 SIF and 198 FTT cases. Operating time and length of stay were significantly lower for the SIF than for FTT (P = .05 and P = .0008). There was no significant difference between the groups for complete flap loss, debulking revisions, and oncologic recurrence.
Conclusion
These results suggest that the SIF reduces length of stay and operating time as compared with FTT in head and neck reconstruction. These findings suggest that the SIF can be considered an alternative reconstructive option to FTT when evaluating intraoral, lateral facial, skull base, and parotidectomy defects, given comparable defect size and tumor biology.
Keywords submental island flap, free flap, complications, oral reconstruction, meta-analysis, systematic review
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