title: The submental flap for oral cavity reconstruction: extended indications and technical refinements.
abstract: OBJECTIVE
  The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. However, its role in composite defects involving the jaw is not clearly defined. Indeed, controversy exists about the flap's interference with an oncologically sound neck dissection
  
  
  METHODS
  A total of 21 patients with oral cavity cancers over a three year period were included. All patients underwent surgical resection and immediate reconstruction with submental flap except one patient who had delayed reconstruction with reversed flap. The flap was used for reconstruction of intra-oral soft tissue defect in 13 patients and composite defects in 8 patients.
  
  
  RESULTS
  Of 21 patients 12 were males and 9 were females, age ranged from 32 to 83 years. The primary tumor sites included buccal mucosa (7), tongue (4), alveolar margin (3), floor of mouth (5) and lip (2). Eventually in this study, we adopted completing the neck dissection first before flap harvest. Complete flap loss occurred in 2 whereas 3 patients had partial flap loss. Follow up ranged from 3 to 44 months, one patient died from metastatic disease. Four patients developed neck recurrences.
  
  
  CONCLUSIONS
  The submental flap is a valid option for reconstruction of intra-oral soft tissue as well as composite oral defects particularly in elderly patients. However, oncologically sound neck dissection should be assured.
authors.affiliation: Surgery department, National Cancer Institute, Cairo, Egypt.
authors.forename: Ayman A
authors.initials: AA
authors.lastname: Amin
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Sakkary
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Khalil
authors.forename: Mohammmed A
authors.initials: MA
authors.lastname: Rifaat
authors.forename: Sherif B
authors.initials: SB
authors.lastname: Zayed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps