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. 2023 Dec;75(4):3432-3438.
doi: 10.1007/s12070-023-03946-4. Epub 2023 Jun 27.

Reconstructing Small-Medium Sized Oral Cavity Defects- Our Experience with the Versatile Famm Flap

Kamal Kishor Lakhera  1 , Pranav Mohan Singhal  1 , Pinakin Patel  1 , Agil Babu  1 , Mahesh Daima  1 , Aishwarya Chatterjee  1 , Suresh Singh  1 , Bhoopendra Singh Gora  1 , Naina Kumar Agarwal  1
Affiliations

Reconstructing Small-Medium Sized Oral Cavity Defects- Our Experience with the Versatile Famm Flap

Kamal Kishor Lakhera et al. Indian J Otolaryngol Head Neck Surg. 2023 Dec.

Abstract

Background: Restoration of form and function of the oral cavity post resection for oral cavity malignancies is an enormous challenge in head and neck reconstructive surgery. The facial artery musculo-mucosal (FAMM) flap is an unexplored, underutilized yet an extremely versatile option for such defects. In this analysis we review the performance of the FAMM flap used to reconstruct tongue/floor of mouth (FOM) defects following tumor resection.

Materials and methods: In this retrospective analysis, demographic and disease profiles of 15 patients with Tongue and Floor of Mouth carcinomas reconstructed with a FAMM flap between January 2019 to January 2021 were studied. Complications and functional outcomes were analyzed.

Results: Fifteen patients (10 men, 5 women) were reconstructed using a FAMM flap. Mean age of the study sample was 46.46 years (28-60 years). One flap was lost due to complete flap necrosis following venous congestion, two other flaps suffered distal tip necrosis. Three patients developed an Oro-cutaneous fistula, with one going on to develop a surgical site infection of the neck wound. Patients reconstructed for FOM defects had an excellent functional outcome. For patients reconstructed for a tongue defect, 33.33% of patients complained of restricted tongue mobility and 44.44% were dissatisfied with the quality of speech post operatively.

Conclusion: The versatile FAMM flap is a reliable, easy to harvest and scarless flap. It provides excellent cosmetic and functional results FAMM flap allowing early resumption of normal daily activities making it an ideal option to reconstruct small to medium sized oral cavity defects.

Keywords: FAMM flap; Floor of mouth; OSCC; Oral cavity; Reconstruction; Tongue.

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Conflict of interest statement

Conflict of interestNone.

Figures

Fig. 1
Fig. 1
a Marking the flap on the buccal mucosa along the trajectory of the facial artery, b The facial artery and vein are secured during neck dissection, c Flap is harvested with the facial artery and vein securely identified and preserved, d Insetting of the flap to cover a tongue defect after a wide local excision for a malignancy
Fig. 2
Fig. 2
Venous congestion of the flap which got relieved after drainage of a neck hematoma
Fig. 3
Fig. 3
Acceptable cosmesis and facial symmetry post reconstruction with FAMM flap
See this image and copyright information in PMC

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