Versatility of the submental island flap in head and reconstruction


  • Mahendra I. Katre Government Cancer Hospital, Aurangabad
  • Prashant Keche Government Cancer Hospital, Aurangabad
  • Arvind Gaikwad Department of ENT and Head Neck Oncology, Government Cancer Hospital, Aurangabad
  • Sunil Deshmukh Government Cancer Hospital, Aurangabad



Head neck cancer, Reconstruction, Locoregional pedicled flap, Submental flap


Background: Head neck cancer is major cause of morbidity and mortality worldwide. India has one of the highest incidences of oral cancer and accounts for about 30% of all new cases annually. Ablative surgery is main stay of treatment which is followed by reconstructive surgery. Microvascular surgery revolutionized onco-reconstruction which requires great expertise even in tertiary cancer centre and it is not possible many times due to long waiting list for it or patient condition. Here there is role locoregional pedicled flap which mitigate this problem to great extent to achieve acceptable functional and aesthetic outcome. One such flap worth to keep in surgeon armamentarium is submental island flap. Submental artery island flap (SIF) is an axial fasciocutaneous flap that includes skin, subcutaneous tissue, platysma, and fat and is pedicled on the submental artery and veins.

Methods: This study conducted in our institute a tertiary level cancer hospital. This is retrospective study. Data extracted from department database between periods February 2015 to May 2017. It includes 12 patients diagnosed with different sub site oral cancer, operated in department of head neck oncology for oral cancer and reconstruction fallowing ablative surgery done by submental island flap by ablative surgeon.  

Results: Submental island flaps are comparable in their outcome with radial forearm free flap. They carry a good color match with facial tissue. It is thin and has a reliable vascular morphology.

Conclusions: When combined with the reported experience of other surgeons, our preliminary experience shows that the SIF is an excellent alternative in the reconstruction of head and neck defects because of its reliability, versatility, and relative ease of application. Neck dissection can plan as an adjunctive procedure to the SIF with certain limitation.

Author Biographies

Mahendra I. Katre, Government Cancer Hospital, Aurangabad

Department Head Neck Oncology Assistant Professor

Prashant Keche, Government Cancer Hospital, Aurangabad

ENT and Head Neck Oncology

Sunil Deshmukh, Government Cancer Hospital, Aurangabad

ENT and Head Neck Oncology


Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v2.0, Cancer incidence and mortality worldwide: IARC Cancer Base No. 10. Lyon, France: International Agency for Research on Cancer; 2010. Available at Accessed on 1 March 2013.

Curado MP, Edwards B, Shin HR, Ferlay J, Heanue M, et al. (eds). Cancer incidence in five continents: Vol. 9, IARC Scientific Publication No. 160. Lyon, France: International Agency for Research on Cancer, 2009. Available at en/publications/pdfs-online/epi/sp160/CI5vol9.pdf. Accessed on 1 March 2013.

Lason DL. Tumour of lip, oral cavity, oropharynx. In: Masthes SJ, ed. Plastic Surgery. 2nd edition Volume 1. Phildelphia: Saunders Elsevier; 2006: 159-187.

Martin D, Baudet J, Mondie JM, Peri G. A prosp du lambeau cutane sous-mental en ilot. Protocole operatoire persperctives D’ulitilisation Ann Chir Plat Esthet. 1990;35:480-4.

Brue E, Bey E, Cariou JL, Faciale L. Rappel embryologique, anatomie descriptive et fonctionnelled’apres une revue de la literature. Ann Chir Plast Esthet. 2000;45:461-84.

Hurwitz DJ, Rabson JA, Futrell JW. The anatomic basis for the platysma skin flap. Plast Reconstr Surg. 1983;72:302-14.

Merten SL, Jiang RP, Caminer D. The submental artery island flap for head and neck reconstruction. ANZ J Surg. 2002;72:121-4.

Magden O, Edizer M, Tayfur V, Atabey A. Anatomic study of the vascularture of the submental artery flap. Plast Reconstr Surg. 2004;114(7):1719- 23

Ramkumar A, Francis NJ, Senthil Kumar R, Dinesh Kumar S. Bipaddled submental artery flap. Int J Oral Maxillofac Surg. 2012;41(4):458-60.

Sterne GD, Januszkiewicz JS, Hall PN, Bardsley AF. The submental island flap. Br J Plast Surg. 1996;49:85–9.

Howard BE, Nagel TH, Donald CB, Hinni ML, Hayden RE. Oncological safety of the submental flap for reconstruction in oral cavity maliginancies. Otolaryngol Head Neck Surg. 2014;150(4):558-62.

Faltaous AA, Yetman RJ. The submental artery flap: an anatomic study. Plast Reconstr Surg. 1996;97:56–60.

Yilmaz M, Menders A, Barutcu A. Submental artery island flap for reconstruction of the lower and mid face. Ann Plast Surg. 1997;39:30–5.






Original Research Articles