Abstract
Objectives: To describe American Head and Neck Society (AHNS) surgeon submental flap (SMF) practice patterns and to evaluate variables associated with SMF complications. Methods: The design is a cross-sectional study. An online survey was distributed to 782 AHNS surgeons between 11/11/16 and 12/31/16. Surgeon demographics, training, practice patterns and techniques were characterized and evaluated for associations with frequency of SMF complications. Results: Among 212 AHNS surgeons, 108 (50.9%) reported performing SMFs, of whom 86 provided complete responses. Most surgeons who performed the SMF routinely reconstructed oral cavity defects with the flap (86.1%, n = 74). Thirty-seven surgeons (43.0%) experienced “very few” complications with the SMF. Surgeons who practiced in the United States versus internationally (p = 0.003), performed more total career SMFs (p = 0.02), and routinely reconstructed parotid and oropharyngeal defects (p = 0.04 and p < 0.001) with SMFs were more frequently perceived to have “very few” complications. SMF surgeons reported more perceived complications with the SMF compared to pectoralis major (p = 0.001) and radial forearm free flaps (p = 0.01). However, similar perceived complications were reported between all three flaps when surgeons performed >30 SMF. Among 94 surgeons not performing SMFs, 71.3% had interest in a SMF training course. Conclusions: Practice patterns of surgeons performing SMFs are diverse, although most use the flap for oral cavity reconstruction. While 43% of surgeons performing the SMF reported “very few” complications, overall complication rates with the SMF were higher compared to other flaps, potentially due to limited experience with the SMF. Increased training opportunities in SMF harvest and inset are indicated.
Original language | English (US) |
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Article number | 102291 |
Journal | American Journal of Otolaryngology - Head and Neck Medicine and Surgery |
Volume | 41 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2020 |
Funding
Financial disclosure: Nothing to disclose. Conflict of interest: Nothing to disclose. Copyright Transfer: In consideration of the American Journal of Otolaryngology's reviewing and editing my submission, “Submental Flap Practice Patterns and Perceived Outcomes: A Survey of 212 AHNS Surgeons,” the author(s) undersigned transfers, assigns and otherwise conveys all copyright ownership to Elsevier Inc. in the event that such work is published in the American Journal of Otolaryngology.
Keywords
- Pectoralis major flap
- Radial forearm free flap
- Submental flap
ASJC Scopus subject areas
- Otorhinolaryngology