Toward a Computed Tomography-Based Protocol for Submental Island Flap Vascular Assessment: Clinical Relevance and Research Outlook

Since its introduction in 1993, the submental island flap (SIF) has become an established option for head and neck reconstruction [1] .Its proximity to recipient sites, relative technical simplicity, and favorable donor-site characteristics makes it suitable for oral cavity, oropharyngeal, and pharyngolaryngeal defects.The oncologic safety of the submental region, with low rates of level I lymph node metastasis in pharyngolaryngeal tumors, further supports its use following cancer resection in these contexts [2] .Despite these advantages, the success of SIF depends on maintaining adequate vascular supply and drainage.Anatomical variations in the submental artery and venous outflow can complicate flap harvest.While the arterial origin is generally consistent, its course relative to the digastric muscle varies.Venous drainage patterns also differ [3] , with outflow directed toward the internal, external, or anterior jugular veins, or combinations thereof.These variations are particularly relevant during neck dissection, where inadvertent injury to dominant venous pathways may compromise flap viability.Preoperative identification of these patterns is therefore important for surgical planning.