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Sonographic Evaluation of the Submandibular Region and Perforators Mapping Before Harvesting a Submental Flap May Reduce Vascular-Related Complications

  • 01st Department of Oncological Surgery with Subunit of Reconstructive and Plastic Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
The Journal of Craniofacial Surgery +

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April 24, 2025

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April 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Preoperative color Doppler ultrasonography (CDU) improves submental flap (SF) reconstruction for head and neck cancers. This imaging technique aids in identifying critical vessels, reducing complications and reoperations for safer, more efficient surgical planning.

Area Of Science

  • Head and Neck Surgery
  • Reconstructive Surgery
  • Diagnostic Imaging

Background

  • The submental flap (SF) is a viable option for head and neck reconstruction.
  • Vascular complications can occur despite the apparent simplicity of SF procedures.
  • Effective preoperative planning is crucial for optimizing SF outcomes.

Purpose Of The Study

  • To assess the utility of preoperative color Doppler ultrasonography (CDU) in planning submental flap (SF) reconstructions.
  • To determine if CDU can reduce vascular complications and the need for reoperations.
  • To establish guidelines for the use of CDU in SF surgery.

Main Methods

  • A comparative study involving 62 patients with oral cavity cancers undergoing SF reconstruction.
  • Group 1: Preoperative CDU for perforator and vascular course assessment.
  • Group 2: Retrospective cohort without preoperative CDU (control).

Main Results

  • Perforators were predominantly identified lateral to the digastric muscle.
  • A trend towards lower flap perfusion disorders was observed in the CDU group (6 vs. 1, P=0.105).
  • Patients who underwent preoperative CDU required fewer reoperations.

Conclusions

  • Preoperative sonographic assessment using CDU is recommended for all SF reconstructions.
  • CDU facilitates precise identification of vessels and their trajectories.
  • This approach enhances the safety and efficiency of submental flap elevation.

Keywords: