Case Report: Use of submental artery perforator flap for reconstructing defects following sinonasal tumor resection.

Background: Sinonasal malignancies (SNMs) invading orbital and maxillofacial structures require complex reconstructive techniques. The submental artery perforator flap (SMAPF) provides a promising reconstructive option due to its vascular reliability and adaptability. Methods: A retrospective study reviewed three patients treated between December 2021 and November 2022 with radical resection of sinonasal malignancies, including orbital content removal. All patients underwent immediate reconstruction using an extended-pedicle SMAPF. The flap pedicle was elongated via microsurgical dissection under 2.5× magnification. Postoperative evaluations were conducted at 1, 3, and 6 months using nasal endoscopy and CT imaging. Results: All flaps survived without vascular compromise. No local recurrence or distant metastasis was observed. Functional and aesthetic outcomes were favorable, with no major complications reported. Conclusions: The extended pedicled SMAPF is a reliable and effective option for one-stage reconstruction of complex orbital and maxillofacial defects following sinonasal malignancy resection. It provides stable vascular support, and functional and aesthetic outcomes meet clinical expectations.