Submental island flap vs free tissue transfer in oral cavity reconstruction: Systematic review and meta-analysis

Background The submental island flap (SMIF) is frequently utilized as an alternative to free tissue transfer (FTT) in oral cavity reconstruction. Methods Studies directly comparing SMIF and FTT for oral cavity defects were included. Data were pooled with random-effects meta-analysis to calculate standardized mean differences and risk differences. Heterogeneity was evaluated with the I-2 statistic. Results Five studies were included in the analysis. The aggregate sample sizes for SMIF and FTT cohorts were 122 and 127, respectively. SMIF was correlated with both reduced operative time and hospitalization by a large effect size. The rate of total flap loss was comparable. SMIF was associated with lower donor site morbidity. There was no difference in the rate of disease recurrence between the two procedures. Conclusions SMIF is associated with less operative time, shorter hospitalization, fewer perioperative complications, and potentially similar disease recurrence rates compared to FTT for the reconstruction of oral cavity defects.