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Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes

  • Authors:
    • Sabine Schreiner
    • Charlotte Maicher
    • Fabian Kraus
    • Miguel Goncalves
    • Stephan Hackenberg
    • Agmal Scherzad
    • Thomas Gehrke
  • View Affiliations / Copyright

    Affiliations: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
    Copyright: © Schreiner et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 50
    |
    Published online on: May 27, 2026
       https://doi.org/10.3892/mco.2026.2959
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Abstract

The submental arterial island flap (SMIF) is used mostly for closing defects in the oral cavity, but also has its uses for oropharyngeal reconstruction. Since the duration of surgery is shorter compared with that for free flaps, it appears to be a good option for patients with severe anesthesiological risk factors. Therefore, the present study evaluated the functional and oncological outcomes of reconstructing defects after oropharyngeal carcinoma resection with a SMIF in these patients. A total of 10 patients underwent resection of lateral oropharyngeal carcinoma and ipsilateral neck dissection with closure of the defects using a SMIF. Oncological evaluation consisted of endoscopic and radiological standard‑of‑care restaging, while functional evaluation included a phoniatric swallowing examination with penetration‑aspiration scale‑score 6 months after surgery. All patients had T2 or T3 carcinoma, while 7 out of 10 patients had nodal involvement. Additionally, 7 out of 10 patients exhibited p16 expression. Pathological clear margins could be achieved in all patients. In all patients, no local, regional or distant recurrence occurred (median follow‑up time, 26 months; range, 12‑33 months). All patients had complete oral intake with their feeding tubes removed, with 1 patient restricted to dysphagia diet. Despite the severe comorbidities, there were no surgery‑related or anesthesia‑related complications. One patient who refused the recommended postoperative radiation developed enoral hair growth requiring regular trimming to avoid dysphagia. The SMIF is a reliable flap for reconstruction of lateral oropharyngeal defects with good oncological and functional outcomes. The reduced anesthesia duration appeared to be beneficial for patients with severe cardiac or pulmonary comorbidities. Male patients should be selected to undergo postoperative radiation to prevent enoral hair growth.
View Figures

Figure 1

Postoperative results. Reconstructive
results at 3 months after surgery in 3 patients from the cohort
following resection of a left-sided lateral oropharyngeal
carcinoma.

Figure 2

Unwanted hair growth. Hair growth on
the transplant of a male patient who rejected the recommended
adjuvant radiation.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Schreiner S, Maicher C, Kraus F, Goncalves M, Hackenberg S, Scherzad A and Gehrke T: Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes. Mol Clin Oncol 25: 50, 2026.
APA
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., & Gehrke, T. (2026). Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes. Molecular and Clinical Oncology, 25, 50. https://doi.org/10.3892/mco.2026.2959
MLA
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., Gehrke, T."Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes". Molecular and Clinical Oncology 25.1 (2026): 50.
Chicago
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., Gehrke, T."Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes". Molecular and Clinical Oncology 25, no. 1 (2026): 50. https://doi.org/10.3892/mco.2026.2959
Copy and paste a formatted citation
x
Spandidos Publications style
Schreiner S, Maicher C, Kraus F, Goncalves M, Hackenberg S, Scherzad A and Gehrke T: Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes. Mol Clin Oncol 25: 50, 2026.
APA
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., & Gehrke, T. (2026). Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes. Molecular and Clinical Oncology, 25, 50. https://doi.org/10.3892/mco.2026.2959
MLA
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., Gehrke, T."Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes". Molecular and Clinical Oncology 25.1 (2026): 50.
Chicago
Schreiner, S., Maicher, C., Kraus, F., Goncalves, M., Hackenberg, S., Scherzad, A., Gehrke, T."Submental artery island flap for reconstruction of lateral oropharyngeal carcinoma in patients with severe anesthesiological risk factors: Functional and oncologic outcomes". Molecular and Clinical Oncology 25, no. 1 (2026): 50. https://doi.org/10.3892/mco.2026.2959
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