(0692) Oral Diet Outcomes After Submental Island Flap Reconstruction of Oral Cavity and Oropharyngeal Cancer Defects

Introduction: The submental island flap has emerged as a versatile reconstructive option in the head and neck, but functional outcomes specific to its use for reconstruction of oral cavity (OC) and oropharyngeal (OP) cancer defects are unknown.

Methods: This retrospective cohort study was performed at a single tertiary care hospital. All patients >18 years of age who underwent submental flap reconstruction of OC and OP cancer defects between April 2016 and July 2023 were included. The primary outcomes were feeding tube dependence and time from surgery to oral (PO) intake.

Results: In total, 93 patients underwent submental flap reconstruction, of which 82 were for OC primary tumors and 11 for OP tumors. In the OC group, ages ranged from 44 to 93 years. Of the first group, 10 (12%) patients in the OC group underwent tracheostomy, and 12 (15%) had segmental mandibulectomy defects. In the OC group, median total operative time (including cancer ablation) was 3 hours and 39 minutes, median time to PO intake was 7 days, and 5 (6%) patients had feeding tube dependence at last follow up. Fifty-two (63%) and 62 (76%) patients were on a diet consisting of solid foods (pureed or more solid) with thin liquids at the time of discharge and at last follow up, respectively. In the OP group, ages ranged from 43 to 83 years. Eight (73%) patients in this group had been previously irradiated and 7 (64%) patients underwent tracheostomy. In the OP group, median total operative time (including cancer ablation) was 5 hours and 34 minutes, median time to PO intake was 7 days, and 4 (36%) patients had feeding tube dependence at last follow up. Overall, 81 (87%) patients underwent evaluation by speech language pathology prior to discharge. There was 1 (1%) flap failure.

Conclusions: The submental flap is a reliable and efficient reconstructive option for a variety of OC and OP defects, with favorable rates of timely resumption of oral diet and the ability to avoid tracheostomy in most cases. The operative time is reasonable and the flap can be performed safely in older patients.