The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome

Background Submental artery island flap (SIF) is a viable alternative to free flaps for selected oral-cavity defects, however, concerns about its oncologic safety still exists. A novel harvesting technique and its outcome is described in here. Methods This is a prospective study for patients with lateralized oral tongue and/or floor of mouth (FOM) cancers who undergone reconstruction using pedicled SIF based on contralateral submental vessels (CSIF) following resection. Results Forty-one patients were included. Twenty-four patients had T2, 13 had T3, and 4 had T1 tumors. The largest flap skin paddle was 15 x 9 cm. One patient sustained complete and five sustained partial flap loss. Three patients developed tongue tethering. Median follow-up was 13.6 months. Locoregional recurrence occurred in 11 patients (26.8%); 6 oral-cavity recurrences (14.6%), 6 ipsilateral, and 1 contralateral neck recurrences (2.4%). Conclusion CSIF is a reliable flap that addresses the oncologic controversy and overcomes the disadvantages of ipsilateral flap.