Vertical Submental Island Flap for Head and Neck Reconstruction

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Regional flaps are essential in head and neck reconstruction, particularly for salvage cases and patients with comorbidities unsuitable for microvascular free flaps.
• Research is exploring the value-based healthcare benefits of regional flaps, including reduced operative time, cost, ICU care, and length of stay compared to free flaps.
• The submental island flap is a well-established axial flap for lower face and oral cavity defects, with less frequent use in midface, temporal, oropharyngeal, and hypopharyngeal reconstructions.

Observation:

• The submental island flap, typically based on a horizontal axis, has seen numerous modifications.
• A novel vertically oriented submental island flap was utilized for maxillary reconstruction.
• This technique facilitated debulking and recontouring of a previous pectoralis flap and addressed submental ptosis.

Findings:

• The vertically based submental island flap provides a viable reconstructive option for complex head and neck defects.
• This modification allows for simultaneous correction of adjacent aesthetic and functional issues, such as submental ptosis.
• The flap's versatility extends its application beyond traditional submental flap indications.

Implications:

• This case highlights a new modification of the submental island flap, expanding its reconstructive potential in head and neck surgery.
• The vertically based approach may offer advantages in specific defect scenarios and patient populations.
• Further investigation into this flap's efficacy and broader applicability in reconstructive surgery is warranted.