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.	杨何平, 张洪武, 陈海蒂, 等. 股前外侧嵌合皮瓣与串联皮瓣修复口腔颌面部肿瘤根治术后缺损的疗效比较. 中国修复重建外科杂志, 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.	张志愿. 口腔颌面外科学. 7版. 北京: 人民卫生出版社, 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, 陈文. 面动脉穿支皮瓣解剖研究及临床应用进展. 中国修复重建外科杂志, 2017, 31(2): 124-128.
15.	潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧面动脉黏膜肌皮瓣整复口腔颌面部缺损的临床应用研究. 华西口腔医学杂志, 2014, 32(4): 355-357.
16.	潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 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. 杨何平, 张洪武, 陈海蒂, 等. 股前外侧嵌合皮瓣与串联皮瓣修复口腔颌面部肿瘤根治术后缺损的疗效比较. 中国修复重建外科杂志, 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. 张志愿. 口腔颌面外科学. 7版. 北京: 人民卫生出版社, 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, 陈文. 面动脉穿支皮瓣解剖研究及临床应用进展. 中国修复重建外科杂志, 2017, 31(2): 124-128.
15. 潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧面动脉黏膜肌皮瓣整复口腔颌面部缺损的临床应用研究. 华西口腔医学杂志, 2014, 32(4): 355-357.
16. 潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 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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