Design and application of submental island "kiss flap"

This study aimed to investigate the clinical effects of the kiss flap and the conventional submental island flap for reconstruction after tongue cancer resection. From March 2023 to March 2025, 60 patients with T2-T4 tongue cancer underwent surgical resection. Of these, 16 patients underwent kiss flap reconstruction, and 44 underwent conventional submental island flap reconstruction. The patients were divided into two groups (kiss flap group and conventional flap group) using a double-blind method. The recovery times for speech, swallowing, tongue movement, and donor site complications were evaluated at the 6-month follow-up. SPSS 26.0 software was used for statistical analysis. There was no significant difference in speech intelligibility between the two groups (clarity: p = 0.717; acceptability: p = 0.823). However, the recovery of swallowing function in the kiss flap group was significantly better than that in the conventional flap group (MTF grade good: p = 0.021; acceptable: p = 0.002). Regarding tension at the donor site, the tension of the kiss flap was significantly lower than that of the conventional flap. Kiss flap repair provides tissue volume to the tongue and preserves its movement, speech intelligibility, and swallowing ability. The limitations of this study, including the unbalanced sample size and short follow-up period, along with the need for long-term aesthetic and functional assessments, are acknowledged and discussed in detail. The kiss flap needs further improvement to reduce complications and enhance patients' quality of life. This study lays a foundation for such further improvement.