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Fatani B, Alhilal AI, Alzahrani HH, Alkhattabi RR, Alhindi M. Facial Reconstruction Using Facial Artery Myomucosal Flap: A Comprehensive Review. Cureus 2023; 15:e42060. [PMID: 37602111 PMCID: PMC10433401 DOI: 10.7759/cureus.42060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
The facial artery myomucosal (FAMM) flap is a type of facial flap that is constructed with the buccal mucosa and submucosa along with a portion of the buccinator muscle, which is connected to nearby blood vessels to maintain its blood supply. It is a versatile and reliable option for head and neck reconstruction, particularly in oral cavity defects. This flap is employed in the reconstruction of the floor of the mouth, alveolar cleft surgery, and tongue defect repair. Previous studies have discussed the use of FAMM flaps for facial reconstructions. However, there are no current and updated comprehensive reviews discussing the use of FAMM flaps in facial reconstruction. In light of this, this study aimed to review all relevant studies that discuss the use of FAMM flaps in facial reconstruction.
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Affiliation(s)
- Bader Fatani
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | | | - Hadeel H Alzahrani
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Raghad R Alkhattabi
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Mariam Alhindi
- Oral and Maxillofacial Surgery, King Saud University, Riyadh, SAU
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Copelli C, Manfuso A, Di Maio P, Garzino-Demo P, Iocca O. Myomucosal island flap in the reconstruction of oral cavity defects: Description of the surgical technique. Head Neck 2023; 45:745-751. [PMID: 36470675 PMCID: PMC10107332 DOI: 10.1002/hed.27251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/06/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Multiple options are available for the reconstruction of the defects of the oral cavity. Among these, the facial artery myomucosal island flap (FAMMIF) is a pedicled flap composed by cheek mucosa, submucosa, and part of the buccinator muscle. The FAMMIF is ideal for the reconstruction of small-to-moderate defects of the oral cavity and the oropharynx. This is due to low operating time, low morbidity, and good functional and aesthetic results. A step-by-step description of the flap harvesting is presented, with particular attention to flap design, identification of the vessels, harvesting of the myomucosal island, tunnel preparation for its passage in the neck and back to the oral cavity, and closure of the cheek donor site with the buccal fat pad.
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Affiliation(s)
- Chiara Copelli
- Division of Maxillofacial Surgery, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Alfonso Manfuso
- Operative Unit of Maxillofacial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy
| | - Pasquale Di Maio
- Department of Otolaryngology - Head Neck Surgery, Hospital of Magenta, Milano, Italy
| | - Paolo Garzino-Demo
- Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, Torino, Italy
| | - Oreste Iocca
- Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, Torino, Italy
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Copelli C, Tewfik K, Cassano L, Pederneschi N, Zompo MRD, Giovine M, Manfuso A. Functional outcomes in tongue reconstruction with myomucosal buccinator flaps. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e163-e169. [PMID: 34753692 DOI: 10.1016/j.oooo.2021.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Buccal myomucosal local flaps in oral cavity reconstruction are a valid option for small-to-moderate defects. Nevertheless, few articles report about functional recovery. The purpose of the present analysis is to evaluate the impact of these flaps on function and quality of life. STUDY DESIGN The study, retrospectively conducted on 36 patients who were surgically treated for tongue cancer between 2012 and 2018 at the Unit of Maxillo-Facial Surgery, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Italy), evaluates functional outcomes using the following 4 questionnaires: Performance Status Scale for Head and Neck Cancer Patients, M.D. Anderson Dysphagia Inventory, Speech Handicap Index, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module. RESULTS All patients are able to eat soft or more solid foods, and most of them eat quietly in public. Although 50% of cases reported a certain degree of dysphagia, it does not impact self-esteem and social relationships. Only 20% of patients have severe problems with speech. However, more than half of the cases (65%) report oral problems. CONCLUSIONS The collected data confirm the suitability of the myomucosal cheek flaps for tongue reconstruction. Most patients report a good functional recovery and satisfactory quality of life even if none of them has a recovery comparable to the presurgical state.
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Affiliation(s)
- C Copelli
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Operative Unit of Maxillo-Facial Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy.
| | - K Tewfik
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - L Cassano
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - N Pederneschi
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - M R Del Zompo
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - M Giovine
- Private Practitioner, University of Foggia, Foggia, Italy
| | - A Manfuso
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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Malinge M, Piot B, Longis J, Nham TT, Anquetil M, Bertin H. The sublingual gland flap: surgical technique and indications for the reconstruction of small oral defects. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Colella G, Rauso R, De Cicco D, Boschetti CE, Iorio B, Spuntarelli C, Franco R, Tartaro G. Clinical management of squamous cell carcinoma of the tongue: patients not eligible for free flaps, a systematic review of the literature. Expert Rev Anticancer Ther 2020; 21:9-22. [PMID: 33081545 DOI: 10.1080/14737140.2021.1840359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The management of squamous cell carcinoma (SCC) of the tongue represents the most demanding treatment planning in head and neck surgery. Ablation followed by free flap reconstruction is considered the gold standard, but not all patients are suitable for this strategy. The aim of this review is to provide a comprehensive view of surgical reconstruction possibilities in patients not eligible for free flaps. METHODS Following PRISMA recommendations, a systematic literature review was conducted searching for original papers that investigated outcomes of patients treated by surgical ablation for tongue SCC followed by reconstruction with local or pedicled flaps. Selected papers were read and data extracted for qualitative analysis. RESULTS Twenty articles met the inclusion/exclusion criteria. The study design was case series in sixteen papers, cohort study in the remaining four. Four different local flaps (BMM, FAMM, NLIF, SMIF) and four regional flaps have been discussed in included studies (IHF, SFIF, SCM, PMMC). CONCLUSION The improved anatomical knowledge makes local flaps a reliable alternative to free tissue transfer in cases requiring small-/medium-sized defects. Regional flaps still represent cornerstones in reconstruction of the tongue. Ease of execution, costs-to-benefit ratio, low-rate complications, minimal donor site morbidity represent the best advantages choosing local/regional flaps.
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Affiliation(s)
- Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Raffaele Rauso
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Ciro Emiliano Boschetti
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Brigida Iorio
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Chiara Spuntarelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Renato Franco
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Gianpaolo Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
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Ferri A, Perlangeli G, Montalto N, Carrillo Lizarazo JL, Bianchi B, Ferrari S, Nicolai P, Sesenna E, Grammatica A. Transoral resection with buccinator flap reconstruction vs. pull-through resection and free flap reconstruction for the management of T1/T2 cancer of the tongue and floor of the mouth. J Craniomaxillofac Surg 2020; 48:514-520. [DOI: 10.1016/j.jcms.2020.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 01/26/2020] [Accepted: 02/14/2020] [Indexed: 01/18/2023] Open
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Use of a Versatile Buccinator Myomucosal Flap in the Palatal Defect. J Maxillofac Oral Surg 2019; 18:388-390. [PMID: 31371879 DOI: 10.1007/s12663-018-1143-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022] Open
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Comini LV, Spinelli G, Mannelli G. Algorithm for the treatment of oral and peri-oral defects through local flaps. J Craniomaxillofac Surg 2018; 46:2127-2137. [DOI: 10.1016/j.jcms.2018.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/23/2018] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
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Ahn D, Lee GJ, Sohn JH. Reconstruction of oral cavity defect using versatile buccinator myomucosal flaps in the treatment of cT2–3, N0 oral cavity squamous cell carcinoma: Feasibility, morbidity, and functional/oncological outcomes. Oral Oncol 2017; 75:95-99. [DOI: 10.1016/j.oraloncology.2017.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/16/2017] [Accepted: 11/04/2017] [Indexed: 12/01/2022]
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Massarelli O, Vaira LA, Biglio A, Gobbi R, Piombino P, De Riu G. Rational and simplified nomenclature for buccinator myomucosal flaps. Oral Maxillofac Surg 2017; 21:453-459. [PMID: 28936552 DOI: 10.1007/s10006-017-0655-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/13/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reconstruction of moderate-sized mucosal defects of the oral cavity or oropharynx represents a surgical challenge. Buccinator myomucosal flaps seem to provide "ideal reconstruction" of oral/oropharyngeal defects because they carry a thin, mobile, well-vascularized, and sensitive tissue, like that excised or lost. Nevertheless, these flaps are not immediately popular because of confusion surrounding the complex terminology used to name them. METHODS After a retrospective study on our experience and a literature review, the authors propose a new rational and simplified nomenclature for the classification of buccinator myomucosal flaps, which clarifies the source vessel, the composition of the flap, and the type of transfer. RESULTS According to this nomenclature, six types of buccinator myomucosal flaps are described. CONCLUSIONS This proposed nomenclature may bring a consensus on the classification of buccinator myomucosal flaps and can help their spread.
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Affiliation(s)
- Olindo Massarelli
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Luigi Angelo Vaira
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy.
| | - Andrea Biglio
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Roberta Gobbi
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Pasquale Piombino
- Department of ENT, University of Campania "Luigi Vanvitelli" Hospital, Via Pansini 5, 08131, Naples, Italy
| | - Giacomo De Riu
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
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Hur MS. Anatomical connections between the buccinator and the tendons of the temporalis. Ann Anat 2017; 214:63-66. [PMID: 28866074 DOI: 10.1016/j.aanat.2017.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/27/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to clarify the anatomical relationship between the buccinator and the temporalis in order to improve understanding of the precise and coordinated movements of the mouth and the mandible. The buccinator and the temporalis were investigated in 72 hemifaces from Korean cadavers. Removing the buccal fat pad from the buccinator revealed that the fascia encircled the space between the superficial and deep tendons of the temporalis laterally, and the external surface of the buccinator medially in all specimens (100%). The fascia was located between the buccinator and the tendons of the temporalis, thereby connecting these two muscles. The fascial space was filled with connective tissue, and the buccal nerve and artery passed through this space. The inferior fibers of the buccinator arose from the anterior portion of the deep tendon of the temporalis in all specimens (100%). The anterior portion of the deep tendon of the temporalis extended forward obliquely between the ramus and body of the mandible. Thus, both the anterior portion of the deep tendon of the temporalis and its attaching inferior muscle fibers of the buccinator coursed obliquely. The above observations indicate that the connecting fascia between the buccinator and tendons of the temporalis and the inferior fibers of the buccinator that were attached to the deep tendon of the temporalis could assist in coordinatation of the movements of the mandibular region and the mouth angle in the timing and strength of contraction of the muscles during mastication, facial expression, and speech.
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Affiliation(s)
- Mi-Sun Hur
- Department of Anatomy, Institute for Translational & Clinical Research, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.
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Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation. Int J Dent 2017; 2016:6548014. [PMID: 28042295 PMCID: PMC5126424 DOI: 10.1155/2016/6548014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/20/2016] [Indexed: 11/18/2022] Open
Abstract
Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any n; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases.
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Remangeon F, Hivelin M, Maurice D, Lantieri L, Laccourreye O. The posterior-based buccinator myomucosal flap (Bozola's flap). Eur Ann Otorhinolaryngol Head Neck Dis 2016; 134:59-62. [PMID: 27697402 DOI: 10.1016/j.anorl.2016.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Based on a case of reconstruction after oncologic resection of the hard palate, the authors document the key technical points for harvesting a posterior-based buccinator myomucosal flap (Bozola's flap), and its limitations and indications after oncologic resection of tumors originating from the oral cavity and/oropharynx.
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Affiliation(s)
- F Remangeon
- Assistance publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges-Pompidou, Service d'Otorhinolaryngologie, 20, rue Leblanc, 75015 Paris, France
| | - M Hivelin
- Assistance publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Service de Chirurgie Plastique et Reconstructrice, 20, rue Leblanc, 75015 Paris, France
| | - D Maurice
- Assistance publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges-Pompidou, Service d'Otorhinolaryngologie, 20, rue Leblanc, 75015 Paris, France
| | - L Lantieri
- Assistance publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Service de Chirurgie Plastique et Reconstructrice, 20, rue Leblanc, 75015 Paris, France
| | - O Laccourreye
- Assistance publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges-Pompidou, Service d'Otorhinolaryngologie, 20, rue Leblanc, 75015 Paris, France.
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Woo SH. Buccinator Myomucosal Flap for Treatment of Osteoradionecrosis of the Mandible. Clin Exp Otorhinolaryngol 2016; 9:85-8. [PMID: 26976033 PMCID: PMC4792249 DOI: 10.21053/ceo.2016.9.1.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 12/26/2014] [Accepted: 01/14/2015] [Indexed: 11/22/2022] Open
Abstract
The use of a myomucosal flap from the buccinator muscle is a valuable reconstruction method for intraoral defects. In this paper, we report the clinical advantages of using a buccinator myomucosal flap for the treatment of partial mandibular defects caused by osteoradionecrosis. We implemented a buccinator myomucosal flap for the reconstruction of a partial mandibular defect in a 55-year-old man with tonsil cancer and partial mandibular defects caused by osteoradionecrosis. The total operating time was 90 minutes. Twelve months after the reconstruction, the patient remains free of disease. A buccinator myomucosal flap can be used for the reconstruction of partial mandibular defects caused by osteoradionecrosis. It is a reliable method for reconstructing small mandibular defects.
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Affiliation(s)
- Seung Hoon Woo
- Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Jinju, Korea ; Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
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Ferrari S, Ferri A, Bianchi B, Varazzani A, Giovacchini F, Sesenna E. Oncologic safety of facial artery myomucosal flaps in oral cavity reconstruction. Head Neck 2015; 38 Suppl 1:E1200-2. [PMID: 26286219 DOI: 10.1002/hed.24191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Buccinator myomucosal flaps are routinely used for oral cavity reconstruction and are indicated mainly in patients classified as having stage N0 cancer. This purpose of this study was to investigate whether preservation of the vascular pedicle of the flap (facial artery and vein) during stadiative neck dissection alters the oncologic safety in these patients. METHODS Fifty patients underwent resection of T1 to 3, N0 squamous cell carcinoma of the tongue or floor of the mouth, stadiative neck dissection, and reconstruction with a facial artery musculomucosal (FAMM) flap were retrospectively analyzed concerning rate of occult neck metastasis and recurrences. RESULTS Occult metastasis was detected in 10 patients. Mean follow-up was 41 months. The overall survival rate was 88%, and the disease-specific survival rate was 92%. CONCLUSION Neck dissection with preservation of the facial artery and vein does not alter the rate of regional recurrences, confirming the oncologic safety of myomucosal flaps in oral cavity reconstruction. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1200-E1202, 2016.
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Affiliation(s)
- Silvano Ferrari
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Andrea Ferri
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Bernardo Bianchi
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Andrea Varazzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Francesco Giovacchini
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Enrico Sesenna
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
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Rahpeyma A, Khajehahmadi S. Inferiorly based buccinator myomucosal island flap in oral and pharyngeal reconstruction. Four techniques to increase its application. Int J Surg Case Rep 2015. [PMID: 26218177 PMCID: PMC4573210 DOI: 10.1016/j.ijscr.2015.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Reconstruction of oral and pharyngeal defects after pathologic resections with the same tissue is an optimal and ideal target. Islanded variety of inferiorly pedicled facial artery musculomucosal flap, in which facial artery and vein are skeletonized (referred to as inferiorly based BUMIF), is suitable for reconstruction of medium-sized mucosal defects. PRESENTATION OF CASES In this article, with four cases, modifications of this flap are demonstrated in reconstruction of large intraoral and oropharyngeal defects and coverage of alveolar ridge in the mandible. DISCUSSION In some situations, there is a need for more mucosal paddle, longer vascular pedicle and more adaptation to the recipient bed. CONCLUSION Relocating Stensen's duct increases the mucosal paddle with cranial extension of superior limit while differential incision of the mucosa and buccinator muscle in mandibular vestibule extend the lower limit of this flap. Bone suture is a good complementary technique when this flap is used for coverage of mandibular alveolar ridge. Inferiorly based BUMIF with added length is indicated for oropharyngeal and contralateral mouth floor reconstructions.
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Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeedeh Khajehahmadi
- Dental Research Center, Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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