The Submental Island Flap for Reconstruction of Temporal Bone Defects

Objective: Untreated cutaneous malignancies involving the lateral aspect of the cranium often invade the temporal bone, necessitating a resection of this site. The reconstruction of the associated complex defect typically requires a reconstructive flap placement to obliterate the resection cavity and provide an aesthetically pleasing restoration. We performed a retrospective case review of 30 patients undergoing temporal bone resection and reconstruction with a submental island flap (SIF), free flap, or temporalis rotation flap. We sought to evaluate the benefit of the submental island flap over the other reconstructive options in terms of cost benefit, patient aesthetic satisfaction, complications, morbidity, and duration of hospitalization. Setting: Tertiary referral center. Patients: Patients who underwent temporal bone resection requiring reconstruction. Intervention(s): Therapeutic. Main Outcome Measure(s): Main outcome measures included time to functional recovery, patient satisfaction, and hospital stay. Results: In total, 30 patients were included in this study. Twenty-three patients received a SIF, three underwent a radial forearm free flap, two underwent a temporalis rotation flap, one received a sternocleidomastoid flap, and one received a myocutaneous flap. Average ICU stay after surgery was under 2 days for non-SIF patients. No SIF patients spent time in the ICU nor were there complications reported in this group. Patients who underwent SIF showed a quicker functional recovery, increased satisfaction with appearance of reconstruction, and improved cosmetic results. Conclusions: Submental island flap reconstruction is an appealing option for the reconstruction of temporal bone defects. This technique offers decreased length of ICU stays, increased patient satisfaction, and decreased complication rates compared with other reconstructive techniques.