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

Ahn, Dongbin; Lee, Gil Joon; Sohn, Jin Ho

doi:10.1016/j.oraloncology.2017.11.007

Cited by 13 publications

(15 citation statements)

References 18 publications

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“… 29 However, in cases of clinical-stage N+ with a therapeutic neck dissection requirement, the significance of preserving facial artery in relation to oncological safety has not yet been established. 3 With regard to technical aspects, cervical lymph node clearance around SMG and relatively large caliber vessels of the pedicle is well feasible. Due to the fact that in a number of studies pathological staging in previously stated clinically N0 neck has detected the occult metastases occurrence even at the level I without oncological safety impairment, 3 , 8 , 12 , 29 the main problem does not appear to be in the presence of lymph node metastases as such, but the manifestation of extranodal extension.…”

Section: Discussionmentioning

confidence: 99%

“… 3 With regard to technical aspects, cervical lymph node clearance around SMG and relatively large caliber vessels of the pedicle is well feasible. Due to the fact that in a number of studies pathological staging in previously stated clinically N0 neck has detected the occult metastases occurrence even at the level I without oncological safety impairment, 3 , 8 , 12 , 29 the main problem does not appear to be in the presence of lymph node metastases as such, but the manifestation of extranodal extension. In our case series, 3 patients underwent reconstruction by a t-FAMMIF-SMG local chimeric flap from the contralateral side to lymph nodes suspicious for metastasis (nos 1 and 4) or contralaterally to primary tumor deeply invading the floor of the mouth (no.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 4 But usually applied free flaps (eg, a radial forearm, lateral arm, or anterolateral thigh perforator flap) 4 , 5 may not be suitable for medium-sized defects (too bulky) and in comorbid patients with poor surgical tolerance and need for a shortened procedure. 3 , 6 For these instances, various local or locoregional flaps may be used. Among these, facial artery myomucosal island flap (t-FAMMIF) or submandibular gland (SMG) flap have previously been proven as versatile, reliable, well-vascularized, and easy to harvest flaps enabling replacement with a similar kind of tissue.…”

mentioning

confidence: 99%

“…From the aesthetic point of view, the donor site of these flaps is hidden or does not create the necessity for an additional external approach in patients undergoing neck dissection, in addition, it is associated with minimal morbidity. 3 , 7 – 12 …”

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confidence: 99%

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Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery

Hauer

Pošta

Genčur

et al. 2022

Journal of Craniofacial Surgery

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The reconstruction of oral tongue and floor of mouth defects after resections of squamous cell carcinoma is a challenging task in reconstructive surgery aiming for appropriate restoration of oral function and quality of life improvement. In this study, the authors introduce the innovative reconstruction technique of medium-sized defects consisting of tunnelized facial artery myomucosal island flap and submandibular gland flap as the local chimeric flap pedicled on facial vessels. A retrospective case series evaluation of 4 patients suffering from oral cavity cancer (stages III and IVa), who underwent transoral tumor excision with neck dissection and immediate reconstruction in the time period September 2020 to July 2021, was conducted. No flap losses or flap-related complications were identified. No recurrences occurred during the follow-up at 11.0±4.5 months (range: 6–16 mo, median=11 mo). Tunnelized facial artery myomucosal island flap and submandibular gland flap local chimeric flap expands the reconstruction options of medium-sized defects after ablative oral cancer surgery in carefully selected patients primarily not suitable for free flap reconstructions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery

Hauer

Pošta

Genčur

et al. 2022

Journal of Craniofacial Surgery

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“…Ahn used a visual analog scale to evaluate swallowing in 22 patients who had buccal myomucosal flap. [9] Scale points were ranging from 0 to 10, with higher scores indicated better swallowing function. Mean scale score was 9.6, which is quite high.…”

Section: Discussionmentioning

confidence: 99%

The Buccal Myomucosal Flap For Reconstruction In Oral Cavity Cancers

Karabulut¹

2020

South Clin Ist Euras

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Objective: We aimed to review our data about the functional outcomes of the buccinator myomucosal flap used for head and neck reconstruction after oncologic ablative surgery. Methods: Retrospective chart analysis was performed of 15 patients between the ages 52 and 78 years (mean age 66 years) who had buccinator myomucosal flaps for oral cavity reconstruction after tumor ablation. All the resections and reconstructions were performed by the first author (BK) at two tertiary referral centers. The demographic feature of the patients, anatomical subsites of the cancer, operation type, flap raising time, total operation time, blood loss during flap harvesting, wound problems and other postoperative complications, decannulation time and postoperative oral feeding time were collected from the patients` medical charts. Results: One patient had minimal distal flap loss. There was no need for additional surgery for this patient. Two patients had partial wound dehiscence, which was resutured in the operating theatre. The donor sites were closed primarily in all cases. One of the patients had wound dehiscence in donor site which healed by secondary intention. Mean flap size was 7x3.2 cm. All flaps needed a second operation for pedicle separation due to the pedicled flap nature. All separations of pedicles were performed using sedation and adequate analgesia in operating theatre without general anesthesia. Mean separation time was 12 days after the first surgery. Three patients had tracheostomy and the mean decannulation time was three days for those. Soft diet was started in the postoperative 2nd day in all patients. However, mean postoperative oral feeding time without any nasogastric tube assistance was five (3-9 days) days. Mean flap harvesting time was 35 minutes (25-49 minutes). Mean intraoperative blood loss during flap harvesting was 25 ml (20-40 ml). Conclusion: Buccinator myomucosal flap should be in the armamentarium of every head and neck surgeon for oral cavity reconstruction.

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Myomucosal island flap in the reconstruction of oral cavity defects: Description of the surgical technique

Copelli

Manfuso

Maio³

et al. 2022

Head & Neck

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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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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

Cited by 13 publications

References 18 publications

Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery

Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery

The Buccal Myomucosal Flap For Reconstruction In Oral Cavity Cancers

Myomucosal island flap in the reconstruction of oral cavity defects: Description of the surgical technique

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