Study On Anatomy And Clinical Application Of Submental Flap

Study on Anatomy and Clinical Application of Submental FlapThe submental flap has been used over 10 years in clinic since it was first introduced. This flap is in the submental region. This flap has reliable arterial blood supply and sufficient venous drainage and can be used in various kinds of flaps for its clinical application. The survival rate of the flap is 93.09%. The common complications such as flap necrosis and the injury of marginal mandibular nerve would be occurred in surgical procedure. Since the applied anatomical research is limited in domestic and complications occur now and again, it is necessary to make further anatomical research in order to guide clinical practice.【Objective】(1) The characteristics of skin and tissue in submental region make the submental flap an available choice for facial and oral reconstructions. Based on the study of the dissection of adult cadavers, this research provides more detailed and complete anatomical and morphological basis for the operation of facial defect repair using the submental flap, and reduces the occurrence of these complications in clinic. (2) By applying this above-mentioned result to the clinic, we observe the clinical cases of the suhmental flap, and appraise the stability and prospect of clinical application.【Method】(1) The submental vessels and the adjacent nerves in 14 formalin-fixed adult cadavers injected with red or black latex were observed and measured in this research and the transparent and perfused examples were made. This research measured detailed anatomical data about the location, dimension, branch, projection, ramus anastomoticus, relationship of the submental vessels and its surrounding. These data were analysed with descriptive statistics, and performed t-test to bilateral key data of thesubmenta]region. (2) Through the observation of clinical cases, experience of the clinical application was summarized.【Result】(1) The submental flap is supplied by the submental vessels, and the submental artery is a constant branch of the facial artery. The distance from the origin of the submental artery to that of the facial artery is 27.16±1.21 mm. The distance from the origin of the submental artery to the lower border of the mandible, the mandibular angle and the middle point of mental are 7.23±2.65 mm , 19.34±5.06 mm, 62.88±6.09 mm respectively. Incidence rate of submenta] artery is 100%. The submental artery is 1.86±0.96mm in diameter at the origin, while the diameter of the submental vein at the origin is 1.97±0.73mm. (2) the submental flap has reliable blood supply and sufficient venous drainage, and it can be transferred with direct or reverse ways, or expanded with tissue expander. After the operation, the flap survives well and produces an excellent color and texture match for facial defects. And it leaves a well-hidden donor site. Patients are satisfied with the result.【Conclusion】(1) The submental artery is a constant and reliable artery as the largest branch of the facial artery in the neck. The location and course of the submental artery are relatively fixed. The submental vein accompanies the submental artery. The submental vessels are reliable arterial blood supply and venous drainage for the submental region, and therefore we can design many types of this flap. (2) The flap has many advantages such as a long pedicle, good blood supply, easy harvesting etc. The donor site is well-hidden and can be closed immediately. (3) The flap can be designed as reversed axial flap or expanded flap with tissue expander for the facial and oral defect. Therefore it can he a routine method for repairing the facial and oral defect.