A comparative study between submandibular-facial artery island flaps (including perforator flap) and submental artery perforator flap: A novel flap in oral cavity reconstruction

• Published in: Oral oncology 2019-12, Vol.99, p.104446-104446, Article 104446
• Main Authors: Ou, Xin-rong, Su, Tong, Huang, Long, Jiang, Can-hua, Guo, Feng, Li, Ning, Min, An-jie, Jian, Xin-chun
• Format: Article
• Language: English
• Subjects: Facial artery perforator; Oral cavity defect; Reconstruction; Submandibular-facial artery island flap; Submental artery perforator flap
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2019.104446

•Submandibular-facial artery island flap (S-FAIF) is a robust, reliable and easy-acquired novel flap.•S-FAIF includes conventional flap based on level II facial artery perforator (FAP) and authentic level I FAP flap.•The first case series of authentic level I FAP flap.•S-FAIF is preferred to submental artery perforator flap when hair problem is considered.•S-FAIF is an excellent addition to reconstructive tools in intraoral reconstruction. The purpose of this study was to introduce submandibular-facial artery island flaps (S-FAIF), including the perforator flap, and to evaluate their application for intraoral reconstruction in comparison with submental artery perforator flaps (SMAPF). Ninety-six patients who underwent intraoral reconstruction using an S-FAIF (n = 34) or SMAPF (n = 62) after cancer resection were recruited in this study. The flap characteristics (viz., pedicle length, flap size, venous drainage pattern, and harvest time), short-term outcomes (viz., flap partial loss, intraoral wound dehiscence, fistula, and wound infection), and long-term morbidity (viz., facial nerve palsy, neck motion restriction, and hair growth) were compared. Nine S-FAIFs were authentic perforator flaps pedicled by level Ⅰ facial artery perforators, while the rest were island flaps based on level Ⅱ facial artery perforators. The survival rates of S-FAIF and SMAPF were both 100 percent. Flap partial loss occurred in two patients in each group. The pedicle length of S-FAIF was shorter than that of SMAPF (p