The Oncological Safety of Submental Flap Reconstruction in Head-and-Neck Cancers: An Extended Follow-up Study

The oncological safety of a submental (SM) flap is thought to be controversial. The objective of our study was to validate our previous study regarding the oncological safety of SM flaps in oral cavity reconstruction. An electronic database was searched from 2015 to 2021 for all head-and-neck tumor patients, where reconstruction was performed using a SM flap. Eighty-eight oral cavity squamous cell carcinoma patients, among whom 71 were males (81.8%), with a mean age of 55.3 years (range: 25-79 years), were retrieved from the database. The sites of involvement were 37 buccal mucosa, 27 lower alveolus, and 24 tongues. The mean follow-up was 33.5 months. The SM flap reconstruction was done for 88 patients; 3 had complete loss of flap, 17 had incomplete loss/partial necrosis, and 68 patients had uneventful recovery of the flap. We had 16 patients with local recurrence. Of these, 4 (4.5%) patients had clear margins and no lymphadenopathy at the level I at the final histopathology report. This study provides validation of the oncological safety of the SM flap and establishes that nodal positivity at level I alone does not contribute to recurrence at the primary site.