Reconstruction of the upper aerodigestive tract with the submental artery flap.

BACKGROUND

: The submental artery flap has rekindled interest in using cervical flaps for reconstruction of head and neck defects. In this article, the authors present their experience with this flap for defects of the upper aerodigestive tract.

METHODS

: This is a retrospective study of 21 patients who underwent upper aerodigestive tract reconstruction with submental artery flaps from 1997 to 2005. The flap was used primarily to reconstruct defects after tumor extirpation, severe infections, and burns. In one case, the flap was used to close an esophagocutaneous fistula. Nine patients had irradiation. Three patients had flap prelamination before transfer.

RESULTS

: The flaps in all 12 patients who had not undergone irradiation survived. With the exception of a small fistula in one patient and transient marginal mandibular nerve palsy in another, none of these patients experienced any major complications. In contrast, six of the nine patients who had been irradiated experienced major complications. These included total flap loss in one, partial flap losses in two, and scar contractures in another three. The difference in major complication rates between these two groups was statistically significant (0 percent versus 67 percent, p < 0.01).

CONCLUSIONS

: In nonirradiated tissues, the submental artery flap is an excellent choice for reconstruction of moderate-sized defects of the upper aerodigestive tract because of its reliability and versatility and the ease with which it can be applied.