Regional Osteocutaneous Submental Island Flap for Premaxillary Reconstruction: A Clinical Experience.

Abstract

Reconstruction of premaxillary defects remains a surgical challenge due to the region's functional and aesthetic importance. While prosthetic rehabilitation and osteocutaneous free flaps are commonly used, they can be resource-intensive or unsuitable for some patients. This study reports our experience using the regional osteocutaneous submental island flap (ROC-SIF) for premaxillary reconstruction. We retrospectively reviewed four patients with premaxillary defects who underwent reconstruction using ROC-SIF between 2017 and 2022. All patients had malignant tumors with no clinical or radiologic evidence of cervical lymph node involvement (N0). Flap harvest technique, intraoperative findings, and postoperative outcomes were analyzed. Defect sizes ranged from 30 to 58 mm. ROC-SIF provided adequate soft tissue coverage and bony support for all cases. Functional outcomes, including speech and swallowing, were acceptable. Aesthetic results were satisfactory to both patients and surgeons. No major flap-related complications occurred. Donor site morbidity was minimal. However, the narrow diameter of the bony component limited its suitability for dental implantation. ROC-SIF is a reliable, cost-effective option for the reconstruction of small to moderate premaxillary defects, particularly in settings where free flap reconstruction is contraindicated or unavailable. Its straightforward harvest, minimal morbidity, and satisfactory functional and aesthetic outcomes make it a viable alternative in selected patients. Further studies with larger cohorts are warranted to better define its role and limitations in oral cavity reconstruction.