Objective: To investigate the clinical utility and key considerations for utilizing the submental island flap in primary reconstruction of defects following surgical treatment of malignancies involving the external ear canal and parotid gland.
Methods: A retrospective analysis was performed on 10 consecutive patients who underwent submental island flap reconstruction for postoperative defects in the external auditory canal-parotid gland region at the Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University from June 1, 2023, to November 30, 2024. Clinical pathological data were analyzed, including flap size, survival rate, venous drainage characteristics, length of postoperative hospital stay, and complications.
Results: Among the 10 patients, 6 were male and 4 were female, aged 51-74 years. Among them, 8 cases were external auditory canal cancer, 4 were squamous cell carcinoma, 2 were adenocarcinoma, and 2 were adenoid cystic carcinoma; 2 were parotid malignant tumors, 1 was a malignant mixed tumor, and 1 was adenoid cystic carcinoma. Six patients had a history of prior surgery or radiotherapy; nine were classified as T4 stage while one was T3 stage. All patients underwent II-III cervical lymph node dissection at the same time, and 2 patients had parotid lymph node metastasis. No metastatic lymph nodes were found in the II-III cervical regions. All the flaps survived without any signs of partial necrosis. The mental -facial vein reconnected to the internal jugular vein in 3 cases (30%), the external jugular vein in 6 cases (60%). In 1 case (10%), the blood flow returned to the anterior jugular vein and the vein was diverted and anastomosed to the internal jugular vein. In the remaining patients, the defect in the auriculotemporal region was successfully repaired by transposition. The average length of hospital stay after surgery was 13 days. Wound infection did not compromise flap blood supply in one patient, while a semicircular canal fistula occurred in another patient; no other significant complications were observed.
Conclusion: The submental island flap is a reliable technique for reconstructing defects following external ear meatus and parotid gland surgery, offering a stable blood supply, high survival rate, and minimal complications.
Keywords: External auditory canal cancer, Parotid gland malignant tumor, Auricular defect, Submental island flap, Reconstruction
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