Laryngoscope Investigative Otolaryngology (Apr 2022)

The submental island flap in head and neck reconstruction: A 10‐year experience examining application, oncologic safety, and role of comorbidity

  • Joseph A. Paydarfar,
  • Peter W. Kahng,
  • Marc A. Polacco,
  • Wenyan Zhao

DOI
https://doi.org/10.1002/lio2.741
Journal volume & issue
Vol. 7, no. 2
pp. 361 – 368

Abstract

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Abstract Background We present our experience on reconstructive versatility and risk of nodal transfer with the submental island flap (SIF). We also examine the role of comorbidity as a predictor of complications. Methods Retrospective cohort study of patients undergoing SIF over 10‐year period. Comorbidity determined using Adult Comorbidity Evaluation 27 index (ACE‐27). Univariable/multivariable logistic regressions performed to determine association of these characteristics and rates of major complications. Results Fifty‐eight patients underwent SIF reconstruction, 27 (45%) patients had moderate/severe comorbidity, and 24 (41%) experienced major complication. Multivariable analysis identified ACE‐27 scores >2 predictive of major flap complications (OR: 17.38, 95% CI: 1.96–153.74, p = .01) and medical complications (OR: 5.8, 95% CI: 1.11–30.23, p = .037). There were no cases of pathologic nodal transfer. Conclusion The SIF is a versatile flap and oncologically safe in carefully selected patients. The ACE‐27 index is strongly predictive of major postoperative complications. Level of Evidence 4

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