Application Of The Submental Artery Island Flap For Repairing The Facial Defect

Objective:Our study is to explode the application of the submental artery island flap for reconstruction of facial tissue defects resulted from infection, trauma, burning or scalding, post-operation of facial carcinoma etc.Methods:There were 10 healthy volunteers. The initiation of the submental artery was measured with acoustic Doppler. The type and size of the submental artery island flap were designed based on the size and location of the facial tissue defects. The incision in the upper margin of the flap was made 1.0 cm below the body of the mandible to avoid the marginal mandibular branch of the facial nerve to the middle line of the mandible and the inferior margin of the flap account for the size of the facial tissue defects with primary closure of the donor site; starting from the operating site, whereas the lateral margin was located below the mandibular angle. With the middle and low defects of the face, we use anterograde flap to repair and upside retrograde. This study collected 10 cases from July of 2007 to March of 2014. The cases included 6 male and 4 female, aged from 22 to 79 (median 51). Primary lesions including trauma (2 cases), buccal mucosa squamous cell carcinoma (SCC) (4 cases), buccal basal cell carcinoma (BCC) (1 cases), and the other three cases suffered from burning or scalding which leaded to perorial scar hyperplasiar. Flap ranging from 30mm*45mm to 40mm* 100mm was designed according to the size and location of the facial defects. There were 8 cases anterograde flaps,2 cases retrograde flaps. Preventive neck dissection was applied in 1SCC case, and there were no lymph nodes metastasize at the following-up times.Results:The distance between the initiation of the artery with the mandibular angle and mandibular margin were measured by acoustic Doppler. The distance between the initiation of the artery with the mandibular angle, mandibular margin and mentum were (7.2±2.6)mm, (19.3±5.1)mm, (62.8±6.1)mm respectively. All flaps showed pale, swell and/or congestion at postoperative time, but the situation improved 5 days after. Of the 10 cases,8 anterograde flaps were survival well,1 of the retrograde flaps had partial necrosis but healed with treatment. Full thickness skin which was used to cover the small partial of donor-site wound in the 2 retrograde flaps cases shrank inordinately at followed-up time. Appearance and functions of the recipient site were satisfactory. The scar of the donor-sites was not conspicuous.Conclusion:The submental artery island flap was similar to the facial soft tissue on color and texture. It offers the advantages of simplicity, reliability and aesthetic result. It can be designed in kinds of anterograde or retrograde or perforator flaps. We believed that it is the excellent choice for repairing the facial defects and deformity.