Submental flap for reconstruction of anterior skull base, orbital, and high facial defects
Research article published in American journal of otolaryngology (2018)
Abstract
PURPOSE: Large anterior skull base, orbital, and high facial defects can present a challenging reconstructive problem. Limited data exists in the literature on the use of a submental flap for reconstructing such defects. We aimed to describe the feasibility, success, and advantages of using variations of the submental flap for reconstruction of anterior skull base, orbital, and high facial defects. MATERIALS & METHODS: Outcomes measured included flap method, flap survival, flap size, reconstructive site complications, donor site complications, and length of hospital stay. RESULTS: Nine patients were identified that underwent submental flap reconstruction of anterior skull base, orbital, or high facial soft tissue defects. There were 5 pedicled, 2 hybridized, and 2 free submental flap reconstructions. Flap survival was 100%. One flap required leech therapy for early post-operative venous congestion. Average flap skin paddle size was 63.7 cm2. Average length of hospital stay was 7.3 days. No complications from the donor site were reported. CONCLUSIONS: Different variations on the submental flap are viable options for reconstruction of high defects in the head and neck. Such flaps have a number of unique qualities that are suitable for reconstruction of anterior skull base, orbital, and high facial defects.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Large anterior skull base, orbital, and high facial defects can present a challenging reconstructive problem.
Why This Matters for Hirudotherapy
This retrospective surgical series of nine patients described variations of the submental flap (pedicled, hybridized, and free) for reconstructing anterior skull base, orbital, and high facial defects, reporting 100% flap survival, an average skin paddle of 63.7 cm2, and 7.3-day average hospital stay, with no donor-site complications; notably, one flap required leech therapy for early post-operative venous congestion. For hirudotherapy this is a concrete real-world documentation point: it shows medicinal leeches being deployed in their established salvage role to relieve venous congestion in a compromised free/pedicled flap, the single most evidence-supported clinical indication for the practice. The caveat is that this is a small single-institution case series focused on flap outcomes, not on leeching; leech use appears in just one patient as an incidental rescue measure, so it speaks to clinical context and not to any controlled evaluation of leech efficacy.
Citation
Submental flap for reconstruction of anterior skull base, orbital, and high facial defects
Chang BA et al. · American journal of otolaryngology, 2018
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