Submental island pedicled flap vs radial forearm free flap for oral reconstruction: Comparison of outcomes

Objective: To compare intraoperative, postoperative, and functional results of submental island pedicled flap (SIPF) against radial forearm free flap (RFFF) reconstruction for tongue and floor-of-mouth reconstruction. Design: Multi-institutional retrospective review. Setting: Academic tertiary referral center. Patients: Consecutive patients from February 2003 to December 2009 undergoing resection of oral tongue or floor of mouth followed by reconstruction with SIPF or RFFF. Intervention: Two groups: SIPF vs RFFF. Main Outcome Measures: Duration of operation, hospital stay, surgical complications, and speech and swallowing function. Results: The study included 60 patients, 27 with SIPF reconstruction and 33 with RFFF reconstruction. Sex, age, and TNM stage were similar for both groups. Mean flap size was smaller for SIPF (36 cm ²) than for RFFF (50 cm²) (P<.001). Patients undergoing SIPF reconstruction had shorter operations (mean, 8 hours 44 minutes vs 13 hours 00 minutes; P<.001) and shorter hospitalization (mean, 10.6 days vs 14.0 days; P<.008) compared with patients who underwent RFFF. Donor site, flap-related, and other surgical complications were comparable between groups, as was speech and swallowing function. Conclusions: Reconstruction of oral cavity defects with the SIPF results in shorter operative time and hospitalization without compromising functional outcomes. The SIPF may be a preferable option in reconstruction of oral cavity defects less than 40 cm ².