Oncological Safety of Contralateral Submental Flap: Case Report and Literature Review

Abstract

Introduction: With the development of pedicle lengthening procedures for submental flap pedicle, it has become possible to this flap based upon the contralateral submental vessels for intraoral reconstruction. The oncological safety of such flap, however, remains to be ascertained.

Case Report: Here we report a case where a contralateral submental island flap was harvested to reconstruct a defect over the left alveolus following excision of a squamous cell carcinoma. The patient developed multiple oncologically positive lymph nodes in the flap bed and also in the contralateral neck at level III.

Discussion: We discuss here the safety of harvesting this flap in oncological cases particularly when there is clinically or radiologically evidence of ipsilateral regional lymph nodes involvement.

Conclusion:  While there is not enough data on contralateral flaps, such flaps should be used with extreme caution where there is a possibility of ipsilateral regional disease.