title: The use of bipaddled submental flap for reconstructing composite buccal defect.
abstract: Reconstruction of full-thickness buccal defect is challenging as two linings need to be addressed. Either two different flaps or double-paddle for one free flaps are necessary for this defect. The prolonged operation might not be tolerated by patients because of advanced age or medical comorbidity. A 77-year-old gentleman, with significant medical comorbidity, presented with a 4.0 × 4.5 cm ulcerative mass due to squamous cell carcinoma arising from the left buccal mucosa. The tumor extended to the left cheek skin. There was no palpable neck node. CT scan did not show any bony erosion or suspicious neck node. Full-thickness resection of the tumour was undertaken. For the full-thickness buccal defect, a bi-paddled pedicled submental flap after de-epithelialization of the flap skin was used for both the cutaneous and mucosal resurfacing. The flap survived completely and patient recovered smoothly. The surgery is simple and operation time is much shorter than free flap reconstruction. This modified utilization of submental flap simplifies the closure of complicated oro-facial wound.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China ; Department of Surgery, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR, People's Republic of China.
authors.forename: Tam-Lin
authors.initials: TL
authors.lastname: Chow
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China.
authors.forename: Chi-Yee
authors.initials: CY
authors.lastname: Choi
authors.affiliation: Department of Maxillofacial and Dental Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China.
authors.forename: Lai-In
authors.initials: LI
authors.lastname: Ho
authors.affiliation: Department of Maxillofacial and Dental Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China.
authors.forename: Siu-Chung
authors.initials: SC
authors.lastname: Fung
keywords: Bipaddled; Buccal; Composite defect; Pedicled flap; Submental flap