The Submental Flap for Reconstruction of Tongue Defects- Surgical Outcome and Quality of Life Assessment

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2895-2900. doi: 10.1007/s12070-023-03858-3. Epub 2023 May 22.

Abstract

Tongue defects following resection of cancers, have a major effect on speech and swallowing, impairing the quality of life. Free flaps such as the free radial artery forearm flap and anterolateral thigh flap have been ideal for the reconstruction of such defects depending upon the volume of tissue loss. Local flaps such as the submental flap and pectoralis major myocutaneous flap serve as an alternative in decreasing morbidity and improving functional outcomes. Surgical outcomes associated with submental flaps used in the reconstruction of tongue defects were evaluated in our study. This is a retrospective analysis of 545 patients, where the submental flap was used for the repair of tongue defects for cancer resections. Oncological safety was studied in 375 patients with a median follow-up of 48 months. 140 patients were studied for their functional outcomes using the parameters, adapted from the University of Washington- Quality of Life questionnaire. Complete flap loss was seen in 15(2.75%) patients while 22(4.03%) patients had partial loss of flap. Locoregional Recurrences, second primary, and distant metastases were noted in 91 of the 375 patients studied. The mean score for swallowing, speech, and taste were 72,71, and 69 respectively. The submental flap is an effective and reliable alternative for the reconstruction of tongue defects.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-03858-3.

Keywords: Free radial artery forearm flap; Locoregional recurrence; Quality of life; Submental flap.