Submental Flap: A Valuable Technique for Tongue Reconstruction

This book chapter presents a case report and discussion on the use of the submental flap for reconstructing a defect in the lateral border of the tongue caused by squamous cell carcinoma. The chapter provides a detailed account of the case presentation, operative procedure, and postoperative period, along with a comprehensive discussion of the submental flap technique.

The case presentation describes a patient with a progressive swelling in the left lateral border of the tongue, clinically suggestive of malignancy. Histopathological examination confirmed moderately differentiated squamous cell carcinoma. The diagnosis was determined to be Stage III (T3N0M0) squamous cell carcinoma involving the left lateral border of the tongue.

The operative procedure involved wide local resection with left hemi glossectomy and reconstruction of the tongue using a submental flap. The tumour was resected with a safe margin, and the defect was measured. The submental flap was marked and raised, preserving its vascular pedicle. The flap was transferred to the oral cavity through a window in the floor of the mouth, and the reconstruction of the tongue was achieved. The donor site in the submental region was closed primarily.

The postoperative period remained uneventful, and satisfactory results were observed during follow-up examinations. Intraoral and worm's eye view photographs demonstrated the satisfactory healing of the reconstructed tongue and the submental flap donor site at nine months of follow-up.

The discussion section of the chapter introduces the submental flap technique, highlighting its significance in reconstructive surgery, particularly in the head and neck region. The surgical technique, including patient evaluation, flap elevation, transposition, and closure, is described in detail. The advantages of the submental flap, such as its proximity to the affected area, robust blood supply, and adequate tissue volume, are discussed. The limitations, including size and location of defects, scar visibility, and potential donor site morbidity, are also addressed.

In conclusion, this book chapter offers valuable insights into the use of the submental flap for reconstructing a defect in the lateral border of the tongue. Through the presentation of a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy and considerations of the submental flap technique in achieving successful outcomes in head and neck reconstructive surgery.