title: The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates.
abstract: OBJECTIVE
  The submental island flap has become increasingly popular in the treatment of intraoral defects following tumor ablation. However, there was concern that the elevation of the pedicled flap might interfere with the efficiency of level I-lymph node dissection and decrease the oncologic prognosis of the patients.
  
  
  METHODS
  In a prospective clinical study over five years the outcome of 45 consecutive patients with intraoral cancer of various T-stages treated with submental island flaps was evaluated and compared to 45 patients with a T-status analogous oral cancer treated with free radial forearm flaps.
  
  
  RESULTS
  All submental island flaps beside three were successful (93.3%). The obtained functional results were pleasing and the donor morbidity low. Patients treated with submental island flaps exhibited no enhanced risk of local tumor recurrence or lymph node metastasis (p<0.86). In contrast, the operation time, time of intensive care and hospitalization were reduced (p<0.001).
  
  
  CONCLUSIONS
  We conclude that the submental island flap is an effective and predictable option of small and medium-sized oral defect treatment. It is a valuable alternative to free flap soft tissue reconstructions such as radial forearm or perforator flaps. It seems particularly beneficial to patients with relevant comorbidities as often present in the oral cancer population. The application of the submental island flap does not reduce the oncological prognosis of oral cancer patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, George-August-University of Goettingen, Germany. Electronic address: Franz-Josef.Kramer@med.uni-goettingen.de.
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Kramer
authors.affiliation: Department of Oral and Maxillofacial Surgery, George-August-University of Goettingen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Böhrnsen
authors.affiliation: Department of Oral and Maxillofacial Surgery, George-August-University of Goettingen, Germany.
authors.forename: Norman
authors.initials: N
authors.lastname: Moser
authors.affiliation: Department of Oral and Maxillofacial Surgery, George-August-University of Goettingen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Schliephake
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Oral cancer; Outcome study; Radial forearm flap; Reconstruction; Submental island flap