Are Submental Flap Reconstructions From Oncological and Reconstructive Perspective Safe? Evaluation and Review of Ipsilateral and Contralateral Submental Flap Reconstructions

This study compared the risk of nodal metastasis progression in the submandibular area when using submental flap contralateral (SFC) or submental flap ipsilateral (SFI) relative to the tumor side. Thirty patients underwent treatment for squamous cell carcinoma of the oral cavity. Submental flap ipsilateral and SFC were used in 14 and 16 patients, respectively. After unilateral supraomohyoid neck dissection (levels I–III), the SFC group showed a significantly higher total number of positive lymph nodes removed (P = 0.014). In addition, the number of positive lymph nodes in the IB region was significantly higher in the SFC group compared with the SFI group (P = 0.001). Tumour relapse was the same in both groups (SFI: n = 4/SFC: n = 4). The authors' results suggest that SFC can be adequately used to reconstruct oral cavity defects because, after rerouting, the rotation arc reaches the upper incisors and covers the arc of SFI rotation in the oral cavity. Moreover, with SFC, a complete neck block dissection and more radical tumor resection can be achieved without limitations.