The Use of Submental Artery Perforator Island Flap Without Including Digastric Muscle in the Reconstruction of Lower Face and Intraoral Defects

Abstract

PURPOSE: For reconstruction of intraoral and lower face defects, it is important to use flaps that prevent reliable and pliable soft tissue and it is possible to use aesthetically most compatible with recipient site. In this study, the authors aimed to present their clinical experiences and results of lower face and intraoral defects reconstructions with submental artery island perforator flap without including the digastric muscle to have a thinner and useful flap. METHODS: Six patients with lower face and intraoral defects that were reconstructed using the submental artery island flap between November 2013 and February 2015 were retrospectively analyzed. Patient demographics, age, sex, defect etiologies, and complications were assessed. SURGICAL TECHNIQUE: Hand Doppler examination was performed and submental artery marked preoperatively. The superior border of the flap was designed at least 1 cm away from the mandibular border to avoid injury to the marginal mandibular nerve and prevent lip eversion. After the identification of the submental artery via the retrograde dissection, the anterior belly of the digastric muscle was not included the flap to prevent a thinner flap. After the dissection, the island flap was transferred to the defect site through a subcutaneous tunnel. The donor sites were closed primarily. RESULTS: A partially flap necrosis was occurred in 1 patient due to hematome in the tunnel around the pedicle. The wound healed uneventfully with conservative management. In the remaining patients there were no complications. CONCLUSION: The submental artery perforator island flap without including the digastric muscle is a reliable and suitable option for the medium-sized defects in the lower face and intraoral defects.