From the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine.
Plast Reconstr Surg. 2022 Mar 1;149(3):511e-514e. doi: 10.1097/PRS.0000000000008859.
Regional flaps are an important component of the reconstructive ladder and represent a versatile option in reconstructing various oral cavity defects. An axial buccal flap based on the facial artery, the facial artery musculomucosal flap, was first described by Pribaz et al. and has been shown to have good functional outcomes with minimal morbidity. Indeed, other surgeons have praised its favorable arc of rotation, reliability, and role as an alternative to free tissue transfer, with shorter duration of general anesthesia and allowance for earlier postoperative mobilization. The facial artery musculomucosal flap has significant versatility, as it can be superiorly or inferiorly based and can be performed in either single- or two-stage fashion. It is of particular advantage for reconstruction of the oral cavity (retromolar trigone, hard palate, alveolar ridge, lip, tongue, and floor of mouth), oropharynx (tongue base, lateral pharynx, and soft palate), and sinonasal structures. Despite its advantages, its widespread use has been limited by a lack of familiarity and difficulty in safely raising a reliable flap consistently. The senior author (S.C.D.) has successfully utilized a high volume of facial artery musculomucosal flaps with a low complication rate in a broad array of oral cavity and oropharyngeal defects. In this article, the authors share technical details on how to harvest and inset this flap by incorporating key landmarks in a reliable fashion.
区域皮瓣是重建阶梯的重要组成部分，是重建各种口腔缺损的多功能选择。基于面动脉的颊动脉轴型皮瓣，由 Pribaz 等人首次描述，具有良好的功能结果，发病率低。事实上，其他外科医生称赞其旋转弧度有利、可靠，并且可以替代游离组织转移，全麻时间更短，允许更早地进行术后活动。面动脉肌黏膜皮瓣具有显著的多功能性，因为它可以在上部或下部作为基础，并可以采用单阶段或双阶段方式进行。它在口腔（磨牙后三角、硬腭、牙槽嵴、唇、舌和口底）、口咽（舌根部、外侧咽和软腭）和鼻-鼻窦结构的重建中具有特别的优势。尽管有这些优点，但由于不熟悉和难以安全可靠地抬起可靠的皮瓣，其广泛应用受到限制。资深作者（S.C.D.）在广泛的口腔和口咽缺损中成功地使用了大量的面动脉肌黏膜皮瓣，且并发症发生率低。在本文中，作者通过可靠的方式融合关键标志，分享了如何采集和插入这种皮瓣的技术细节。
