Jowett Nathan, Hadlock Tessa A, Sela Eyal, Toth Miklos, Knecht Rainald, Lörincz Balazs B
Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA.
Auris Nasus Larynx. 2017 Apr;44(2):220-226. doi: 10.1016/j.anl.2016.07.004. Epub 2016 Jul 21.
To objectively assess donor site morbidity after harvesting the facial artery musculomucosal flap. Use of the FAMM-flap in oral cavity reconstruction remains sporadic. This case series describes our newly developed standardized assessment of this flap in a floor of mouth (FOM) reconstructive setting.
Standardized postoperative assessment of the FAMM flap for donor site wound complications, functional, facial mimetic and oncologic outcomes.
There were no wound complications. Oral competence remained intact, tongue mobility was good to excellent, average word articulation score was 98%, and mimetic function excellent in all patients. Three patients experienced ipsilateral upper lip anesthesia, and five patients were noted to have slight dysfunction of the orbicularis oris resulting in a loss of lip height at rest.
The FAMM flap is a reliable option for reconstruction of ablative defects of the FOM, and should be considered a workhorse flap for oral cavity defects. Unlike the submental island flap, a complete level I dissection may be concurrently performed without compromising the vascular supply to the FAMM flap.
客观评估切取面动脉肌黏膜瓣后供区的并发症。面动脉肌黏膜瓣在口腔重建中的应用仍然较少。本病例系列描述了我们在口底重建中对该皮瓣新开发的标准化评估。
对面动脉肌黏膜瓣供区伤口并发症、功能、面部表情及肿瘤学结局进行标准化术后评估。
未出现伤口并发症。所有患者口腔功能保持完好，舌活动度良好至极佳，平均言语清晰度评分达98%，面部表情功能极佳。3例患者出现同侧上唇麻木，5例患者被发现口轮匝肌轻度功能障碍，导致静息时唇高降低。
面动脉肌黏膜瓣是口底切除性缺损重建的可靠选择，应被视为口腔缺损的常用皮瓣。与颏下岛状皮瓣不同，在不影响面动脉肌黏膜瓣血供的情况下可同时进行完整的Ⅰ级解剖。
