DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205634

A rare case of bilateral buccal lesions reconstructed with bipaddle submental artery island flap and buccal fat pad flap along with review of literature

Viresh Arora, Bhushan Kathuria, Madhuri Arora

Abstract


Reconstruction of full-thickness buccal defect involving oral commissure which demanding, it requires restoring competency of commissure besides providing lining for two surfaces simultaneously. Such defects prerequisites a pedicled flap each for mucosal and cutaneous surfaces else a free flap with double-paddle skin is needed. We present a case of a 45-year-old gentleman with bilateral buccal mucosa lesions; left side proliferative squamous cell carcinoma (T4N0M0) infiltrating into the cheek and right-sided large verrucous lesion. Reconstruction of verrucous lesion defect was done with buccal fat pad flap following wide local excision, while the SCC lesion resulting defect was reconstructed with de-epithelized bipaddle submental artery island flap (SAIF). Postoperatively patient had an uneventful recovery. The bipaddled SAIF has emerged as innovative modification of the conventional submental flap for reconstruction of composite oro-facial wounds provides lining for both surfaces, requires a shorter operative time than a free flap and avoids donor site deformity associated with double paddled Pectoralis cutaneous flap. The complexity of bilateral buccal defects and utilization of bipaddled design for reconstruction warrants submission of this case with just two cases reported in the literature.  


Keywords


Buccal carcinoma, Submental artery island flap, Bippaddle flap, Cheek

Full Text:

PDF

References


Yadav P. Reconstructive surgery in oral cancers. Indian J Plast Surg. 2007;40:22.

Genden EM, Rinaldo A, Sua´rez C, Wei WI, Bradley PJ, Ferlito A. Complications of free flap transfers for head and neck reconstruction following cancer resection. Oral Oncol. 2004;40:979-84.

Chow TL, Chan TTF, Chow TK, Fung SC, Lam SH. Reconstruction with submental flap for aggressive orofacial cancer. Plast Reconstr Surg. 2007;120:431-6

Sebastian P, Thomas S, Varghese BT, Iype EM, Balagopal PG, Mathew PC. The submental island flap for reconstruction of defects in oral cancer patients. Oral Oncol. 2008;44:1014-18

Paydarfar JA, Patel UA. Submental island pedicled flap vs radial forearm free flap for oral reconstruction. Comparison of outcomes. Arch Otolaryngol Head Neck Surg. 2011;137:82-7.

Ramkumar A, Francis NJ, Senthil Kumar R, Dinesh Kumar S. Bipaddled submental artery flap. Oral Maxillofac Surg. 2012;41:458-60.

Chow TL, Choi CY, Ho LI, Fung SC. The use of bipaddled submental flap for reconstructing composite buccal defect. J Maxillofac Oral Surg. 2014;13:75-7.

Martin D, Pascal JF, Baudet J, Mondie JM, Farhat JB, Athoum A, Le Gaillard P, Peri G. The submental island flap:a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993;92:867-73.

Chen WL, Yang ZH, Li JS, Huang ZQ, Wang JG, Zhang B. Submental flap for reconstructing tongue defect with V-Y advancement flap for repairing submental defect. Otolaryngol Head Neck Surg. 2009;141:202-6.

Curran AJ, Neligan P, Gullane PJ. Submental artery island flap. Laryngoscope. 1997;107:1545-9.

Pistre V, Pelissier P, Martin D, Lim A, Baudet J. Ten years of experience with the submental flap. Plast Reconstr Surg. 2001;08:1576-81

Conroy FJ, Mahaffey PJ. Intraoral flap depilation using the pulsed alexandrite laser. J Plast Reconstr Aesthet Surg. 2009;62:e421-3

Reus WF III, Colen LB, Straker DJ. Tobacco smoking and complications in elective microsurgery. Plast Reconstr Surg. 1992;89:490-4.

Chang LD, Buncke G, Slezak S, Buncke HJ. Cigarette smoking, plastic surgery, and microsurgery. J Reconstr Microsurg. 1996;12:467-74.

Liu M, Liu W, Yang X, Guo H, Peng H. Pectoralis Major Myocutaneous Flap for Head and Neck Defects in the Era of Free Flaps: Harvesting Techniques and Indications. Sci Rep. 2017;7:46256.