title: Submental artery island flap in intraoral reconstruction: a review.
abstract: BACKGROUND
  The submental flap was first introduced 20 years ago (1993). Advances in techniques and new findings from anatomic studies expanded the indications and improved the flap characteristics. Indications, limitation, and all possible variants of this flap are discussed comprehensively in this article.
  
  
  METHODS
  A literature review was performed. We paid attention to the anatomy of submental region, and especially to submental artery and vein, muscles and lymphatics. Surgical techniques for each possible variant of this flap and examples of each situation are presented. Indications of submental flap for facial, oesophageal, pharyngeal, laryngeal, and oral cavity reconstruction were assessed.
  
  
  RESULTS
  Ninety studies meeting the inclusion criteria were reviewed. Classification of the submental flap based on skin paddle composition and blood supply is presented. Major modifications such as pedicled, free, and perforator flaps are discussed comprehensively and minor variants of submental flap such as bipaddled, bipedicled, expanded, deepithelialized, and interposition submental flaps are discussed, briefly. A historical look at this topic is presented to show how and by whom advances in submental flap were done.
  
  
  CONCLUSIONS
  The submental flap has a wide arc of rotation; it is easy to rise and has low donor site morbidity. It is a safe, simple, and predictable method for reconstruction of oral cavity.
authors.affiliation: Assistant Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad 91735-984, Iran. Electronic address: rahpeymaa@mums.ac.ir.
authors.forename: Amin
authors.initials: A
authors.lastname: Rahpeyma
authors.affiliation: Assistant Professor of Oral and Maxillofacial Pathology, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: khajehahmadis@mums.ac.ir.
authors.forename: Saeedeh
authors.initials: S
authors.lastname: Khajehahmadi
mesh_terms: D006801:Humans; D009055:Mouth / Q000601:surgery*; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation; D009334:Neck Muscles / Q000098:blood supply / Q000637:transplantation*; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*
keywords: Oral reconstruction; Submental artery; Submental flap