Oral Diet Outcomes and Tracheostomy Avoidance After Submental Flap Reconstruction of Oral and Oropharyngeal Defects

The submental island flap can be used to reconstruct defects of the oral cavity and oropharynx. The objective of this study is to describe functional outcomes after this reconstruction.

Retrospective chart review was performed for 82 patients who underwent submental flap reconstruction of oral cavity cancer defects and 11 with oropharyngeal cancer defects. Primary outcomes were feeding tube use at last follow-up and time from surgery to first oral intake. The secondary outcome was the need for tracheostomy.

Feeding tube use at last follow-up was 9% in the oral cavity group and 36% in the oropharynx group. Median time to oral intake was 7 days in both groups. Tracheostomy was avoided in 87% of oral cavity patients and in 46% of oropharynx patients. In regression analysis of the entire cohort, the outcomes of persistent feeding tube use at last follow-up and tracheostomy were associated with the following variables: prior irradiation, oropharyngeal primary site, and adjuvant treatment status. Among the oral cavity group, prior irradiation was associated with persistent feeding tube use.

The submental flap can be used in a wide range of oral cavity and oropharyngeal defects, even in elderly patients. This flap can be performed for oral cancers with avoidance of tracheostomy in most cases and reliable resumption of oral diet.

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