Submental Island Flaps for Lateral Reconstruction: Technical Refinements for Optimal Outcomes and Resource Efficiency

• Authors: Melissa S. Oh, Emory University; Nikhil T. Vettikattu, Emory University; H. Michael Baddour, Emory University; Jennifer Gross, Emory University; Brian Joshua Boyce, Emory University; Mihir R. Patel, Emory University; Nicole C. Schmitt, Emory University; Clementino Solares Rivera, Emory University; Jackson Vuncannon, Emory University; Azeem S. Kaka, Emory University
• Journal Title: OTO Open
• Volume: Volume 8, Number 2
• Publisher: Wiley Periodicals LLC | 2024-04, Pages e131-None
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/oto2.131
• Subjects: Biology, Virology; Health Sciences, Medicine and Surgery
• Keywords: COVID‐19; lateral facial; mastoidectomy; parotid; reconstruction; regional flap; submental island flap; temporal bone

Abstract

Objective To describe our modifications to the submental island flap (SMIF) in a case series that demonstrates improved reproducibility, shortened length of stay (LOS), and reduced utilization of hospital resources. Study Design This retrospective case series with chart review included adult patients who underwent resection of malignant or benign tumors resulting in lateral facial, parotid, or temporal bone defects, which were reconstructed with SMIF. Setting A tertiary‐care academic referral center. Methods Retrospective case series included all adult patients who underwent SMIF reconstruction between March 2020 and August 2021. Patient demographic and clinical data were collected. Primary outcomes were measures of hospital utilization including duration of surgery, LOS, and postoperative outcomes. Results Twenty‐eight patients were included with a mean age of 71.7 years. Eighty percent were male. All patients underwent parotidectomy, and the mean operative time was 347 minutes. The median LOS was 2.5 days (range 0‐16 days). Seventy‐five percent of the flaps drained into the internal jugular vein, and 25% drained into the external jugular vein. No patients required reoperation or readmission. All flaps survived. Conclusion SMIFs are a safe and effective option for reconstruction of lateral facial, parotid, and temporal bone defects. Compared to free flap reconstruction, SMIFs offer reduced length of surgery, decreased use of health care resources, and lower rate of reoperation. As health care resource allocation is increasingly important, the SMIF offers an excellent alternative to free flap reconstruction of lateral defects.