The Oncological Safety of Submental Flap Reconstruction in Head and Neck Cancers: An Extended Follow-up Study

Abstract

Introduction: The oncological safety of a submental flap is thought to be controversial. The objective of our study was to validate our previous study regarding the oncological safety of submental flaps in oral cavity reconstruction. Materials and Methods: An electronic database was searched from 2015 to 2021 for all head and neck tumour patients, where reconstruction was performed using a submental flap. Results: Eighty-eight oral cavity squamous cell carcinoma patients, amongst whom 71 were males (81.8%), with a mean age of 55.3 years (range: 25-79 years), were retrieved from the database. The sites of involvement were 37 buccal mucosa, 27 lower alveolus and 24 tongue. The mean follow-up was 33.5 months. The submental flap reconstruction was done for 88 patients; 3 had complete loss of flap, 17 had incomplete loss/partial necrosis, and 68 patients had uneventful recovery of the flap. We had 16 patients with local recurrence. Of these, 4 (4.5%) patients had clear margins and no lymphadenopathy at the level I at the final histopathology report. Conclusion: This study provides validation of the oncological safety of the submental flap and establishes that nodal positivity at level 1 alone does not contribute to recurrence at the primary site.