Comparative Analysis of Radial Forearm Free Flap and Submental Island Flap in Reconstruction of Post-glossectomy Defects of Oral Squamous Cell Carcinoma and Quality of Life Assessment

Abstract

Aim: Reconstruction of tongue defects has always been a challenging aspect of onco-surgery. Although a variety of locoregional and free flaps have been advocated, it still poses a challenge due to its complex function in deglutition and speech articulation. Hence, this study aims at reducing the dilemma of flap selection for better patient outcome. Materials and Methods: Among 16 tongue carcinoma cases, 6 cases were reconstructed using submental island flap (SIF) and 10 using radial forearm free flap (RFFF). These 2 flaps were compared in terms of parameters like intraoperative time, hospital stay, overall survival, pain, cosmesis, and recreation of anatomy, and functions like deglutition and articulation of speech. Patients were followed for oncologic safety and recurrence. Obtained data were statistically analysed using IBM® SPSS®. Result: SIF showed significantly higher activity score (P = 0.001) with reduced flap harvest time (P = 0.014) but showed difficulty in deglutition (P = 0.03) compared to RFFF. It was concluded that in cases of RFFF mobility and functional outcome was superior, but flap harvest time was considerably higher. Overall patient survival rate was better in cases of RFFF in long-term follow-up, but flap survival rate was significantly higher in SIF owing to better vascularity. Conclusion: In highly compromised cases and salvage cases where microvascular flaps are contraindicated, submental flap being a local flap with comparable overall survival rate, better cosmesis hence, serves as a reliable flap for reconstruction of glossectomy defects. © The Association of Oral and Maxillofacial Surgeons of India 2024.