Submental flap for reconstruction of anterior skull base, orbital, and high facial defects

Publication date: Available online 22 November 2018

Source: American Journal of Otolaryngology

Author(s): Brent A. Chang, S. Ryan Hall, Brittany E. Howard, Gregory S. Neel, Carrlene Donald, Devyani Lal, Thomas H. Nagel, Richard E. Hayden

Abstract

Purpose

Large anterior skull base, orbital, and high facial defects can present a challenging reconstructive problem. Limited data exists in the literature on the use of a submental flap for reconstructing such defects. We aimed to describe the feasibility, success, and advantages of using variations of the submental flap for reconstruction of anterior skull base, orbital, and high facial defects.

Materials & methods

Outcomes measured included flap method, flap survival, flap size, reconstructive site complications, donor site complications, and length of hospital stay.

Results

Nine patients were identified that underwent submental flap reconstruction of anterior skull base, orbital, or high facial soft tissue defects. There were 5 pedicled, 2 hybridized, and 2 free submental flap reconstructions. Flap survival was 100%. One flap required leech therapy for early post-operative venous congestion. Average flap skin paddle size was 63.7 cm². Average length of hospital stay was 7.3 days. No complications from the donor site were reported.

Conclusions

Different variations on the submental flap are viable options for reconstruction of high defects in the head and neck. Such flaps have a number of unique qualities that are suitable for reconstruction of anterior skull base, orbital, and high facial defects.

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