Effect of facial artery musculo-mucosal flap in reconstructing defects of tongue and mouth floor_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

PAN Mengxiong ,  MAO Junwu , MA Tao , QIN Xiaorong , LI Bo

Departmentof Oral and Maxillofacial Surgery, the Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541001, P.R.China;

Corresponding?author：

MAO Junwu, Email: 13367737080@163.com

Keywords：

Tongue or floor of mouth defects; facial artery musculo-mucosal flap; malignancy

DOI：

10.7507/1002-1892.201611108

Video：

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Objective To explore the effect of facial artery musculo-mucosal (FAMM) flap to reconstruct tongue and floor of mouth defects. Methods Between January 2011 and January 2016, 24 cases of tongue and floor of mouth defects were repaired with FAMM flap after tumor resection. There were 16 males and 8 females, aged from 38 to 70 years with an average of 55 years. The disease duration was from 1 week to 6 months with an average of 4 months. The defect located at the floor of mouth in 4 cases, at the tongue in 15 cases, and both tongue and floor of mouth in 5 cases. There were 2 cases of carcinoma at the floor of mouth, 2 cases of adenoid cystic carcinoma at the floor of mouth, 14 cases of carcinoma at the tongue, 1 case of adenoid cystic carcinoma at the tongue, and 5 cases of carcinoma at the tongue and floor of mouth. The size of defect ranged from 4 cm×3 cm to 8 cm×7 cm. Three ipsilateral and 21 contralateral FAMM flaps were harvested (5 cases were repaired with FAMM flap and submental muscle island flap due to the large defect area). The size of FAMM flap ranged from 5 cm×4 cm to 5 cm×5 cm, the size of submental muscle island flap ranged from 4 cm×3 cm to 5 cm×4 cm. Results All flaps survived after operation, without local necrosis. Wound dehiscence at donor site occurred in 5 cases, and healed after cleaning; primary healing was obtained in the other 19 cases. All the patients were followed up 8 months to 5 years with an average of 2 years and 4 months. No obvious facial deformity or fistula of the floor of mouth occurred after operation. Injury of the submandibular branch of the facial nerve was observed in 16 patients, who returned to normal at 3 months. All 24 patients had limitation of mouth opening after operation, which disappeared after 12 months. The functions of speech, chewing, and swallowing were normal. Conclusion FAMM flap has many advantages of simple operation, good repair, high flap survival rate, and less injury at donor site for repairing tongue and floor of mouth defects.

Citation： PAN Mengxiong, MAO Junwu, MA Tao, QIN Xiaorong, LI Bo. Effect of facial artery musculo-mucosal flap in reconstructing defects of tongue and mouth floor. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(4): 461-464. doi: 10.7507/1002-1892.201611108 Copy

1.	?楊何平, 張洪武, 陳海蒂, 等. 股前外側嵌合皮瓣與串聯皮瓣修復口腔頜面部腫瘤根治術后缺損的療效比較. 中國修復重建外科雜志, 2016, 30(4): 447-452.
2.	Pribaz J, Stephens W, Crespo L, et al. A new intraoral flap: facial artery musculomucosal (FAMM) flap. Plast Reconstr Surg, 1992, 90(3): 421-429.
3.	Ayad T, Kolb F, De Mones E, et al. The musculo-mucosal facial artery flap: harvesting technique and indications. Ann Chir Plast Esthet, 2008, 53(6): 487-494.
4.	Ayad T, Kolb F, De Mones E, et al. Reconstruction of floor of mouth defects by the facial artery musculo-mucosal flap following cancer ablation. Head Neck, 2008, 30(4): 437-445.
5.	Baj A, Rocchetta D, Beltramini G, et al. FAMM flap reconstruction of the inferior lip vermilion: surgery during early infancy. J Plast Reconstr Aesthet Surg, 2008, 61(4): 425-427.
6.	Bonawitz SC, Duvvuri U. Robotic-assisted FAMM flap for soft palate reconstruction. Laryngoscope, 2013, 123(4): 870-874.
7.	Heller JB, Gabbay JS, Trussler A, et al. Repair of large nasal septal perforations using facial artery musculomucosal (FAMM) flap. Ann Plast Surg, 2005, 55(5): 456-459.
8.	Pribaz JJ, Meara JG, Wright S, et al. Lip and vermilion reconstruction with the facial artery musculomucosal flap. Plast Reconstr Surg, 2000, 105(3): 864-872.
9.	Wolber A, Mallet Y, Avalos N, et al. Sensory function of FAMM flap: a report of 15 cases. Ann Chir Plast Esthet, 2009, 54(2): 120-125.
10.	Sohail M, Bashir MM, Khan FA, et al. Comparison of Clinical Outcome of Facial ArteryMyomucosal Flap and Tongue Flap for Closure of Large Anterior Palatal Fistulas. J Craniofacial Surg, 2016, 27(6): 1465-1468.
11.	張志愿. 口腔頜面外科學. 7版. 北京: 人民衛生出版社, 2012: 369-370.
12.	Ayad T, Xie L. Facial artery musculomucosal flap in headand neck reconstruction: a systematic review. Head Neck, 2015, 37(9): 1375-1386.
13.	Jowett N, Hadlock TA, Sela E, et al. Facial mimetic, cosmetic, and functional standardized assessment of the facial artery musculomucosal (FAMM) flap. Auris Nasus Larynx, 2017, 44(2): 220-226.
14.	王迪, 陳文. 面動脈穿支皮瓣解剖研究及臨床應用進展. 中國修復重建外科雜志, 2017, 31(2): 124-128.
15.	潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側面動脈黏膜肌皮瓣整復口腔頜面部缺損的臨床應用研究. 華西口腔醫學雜志, 2014, 32(4): 355-357.
16.	潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側頦下島狀皮瓣整復口腔頜面部缺損的臨床應用. 國際口腔醫學雜志, 2011, 38(1): 22-26.
17.	Coronel-Banda ME, Serra-Renom JM, Lorente M, et al. Mucosal perforators from the facial artery. Br J Oral Maxillofac Surg, 2014, 52(6): 535-538.
18.	Coronel-Banda ME, Serra-Renom JM, Lorente M, et al. Cheek mucosa territories perfused by perforators from the facial artery. Int J Oral Maxillofac Surg, 2015, 44(1): 29-33.

1. ?楊何平, 張洪武, 陳海蒂, 等. 股前外側嵌合皮瓣與串聯皮瓣修復口腔頜面部腫瘤根治術后缺損的療效比較. 中國修復重建外科雜志, 2016, 30(4): 447-452.
2. Pribaz J, Stephens W, Crespo L, et al. A new intraoral flap: facial artery musculomucosal (FAMM) flap. Plast Reconstr Surg, 1992, 90(3): 421-429.
3. Ayad T, Kolb F, De Mones E, et al. The musculo-mucosal facial artery flap: harvesting technique and indications. Ann Chir Plast Esthet, 2008, 53(6): 487-494.
4. Ayad T, Kolb F, De Mones E, et al. Reconstruction of floor of mouth defects by the facial artery musculo-mucosal flap following cancer ablation. Head Neck, 2008, 30(4): 437-445.
5. Baj A, Rocchetta D, Beltramini G, et al. FAMM flap reconstruction of the inferior lip vermilion: surgery during early infancy. J Plast Reconstr Aesthet Surg, 2008, 61(4): 425-427.
6. Bonawitz SC, Duvvuri U. Robotic-assisted FAMM flap for soft palate reconstruction. Laryngoscope, 2013, 123(4): 870-874.
7. Heller JB, Gabbay JS, Trussler A, et al. Repair of large nasal septal perforations using facial artery musculomucosal (FAMM) flap. Ann Plast Surg, 2005, 55(5): 456-459.
8. Pribaz JJ, Meara JG, Wright S, et al. Lip and vermilion reconstruction with the facial artery musculomucosal flap. Plast Reconstr Surg, 2000, 105(3): 864-872.
9. Wolber A, Mallet Y, Avalos N, et al. Sensory function of FAMM flap: a report of 15 cases. Ann Chir Plast Esthet, 2009, 54(2): 120-125.
10. Sohail M, Bashir MM, Khan FA, et al. Comparison of Clinical Outcome of Facial ArteryMyomucosal Flap and Tongue Flap for Closure of Large Anterior Palatal Fistulas. J Craniofacial Surg, 2016, 27(6): 1465-1468.
11. 張志愿. 口腔頜面外科學. 7版. 北京: 人民衛生出版社, 2012: 369-370.
12. Ayad T, Xie L. Facial artery musculomucosal flap in headand neck reconstruction: a systematic review. Head Neck, 2015, 37(9): 1375-1386.
13. Jowett N, Hadlock TA, Sela E, et al. Facial mimetic, cosmetic, and functional standardized assessment of the facial artery musculomucosal (FAMM) flap. Auris Nasus Larynx, 2017, 44(2): 220-226.
14. 王迪, 陳文. 面動脈穿支皮瓣解剖研究及臨床應用進展. 中國修復重建外科雜志, 2017, 31(2): 124-128.
15. 潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側面動脈黏膜肌皮瓣整復口腔頜面部缺損的臨床應用研究. 華西口腔醫學雜志, 2014, 32(4): 355-357.
16. 潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側頦下島狀皮瓣整復口腔頜面部缺損的臨床應用. 國際口腔醫學雜志, 2011, 38(1): 22-26.
17. Coronel-Banda ME, Serra-Renom JM, Lorente M, et al. Mucosal perforators from the facial artery. Br J Oral Maxillofac Surg, 2014, 52(6): 535-538.
18. Coronel-Banda ME, Serra-Renom JM, Lorente M, et al. Cheek mucosa territories perfused by perforators from the facial artery. Int J Oral Maxillofac Surg, 2015, 44(1): 29-33.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of facial artery musculo-mucosal flap in reconstructing defects of tongue and mouth floor

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