OP017: The Oxford experience with Buccinator and FAMM flaps for oral cavity and oropharyngeal reconstruction

Abstract

Purpose The Buccinator and Facial Artery Musculo-Mucosal (FAMM) flaps can be used to reconstruct a wide range of intra-oral defects including floor of mouth, tonsillar fossa and lateral tongue. We describe our experience with the Buccinator and FAMM flaps in the aforementioned areas and a novel use for the reconstruction of oropharyngeal tumours at the tongue base and lateral pharyngeal wall. Materials and methods We retrospectively reviewed all patients who underwent Buccinator and FAMM flap reconstruction examining indication, operative details, and post-operative outcomes. We describe our technique for its novel use in lateral pharynx/tongue base reconstruction through neck dissection access. Results There were no flap failures with all patients achieving primary healing with minimal complications. All donor sites closed directly with mouth opening at pre-operative status by 21 days post-op. Deeper flaps were adequately visualised and monitored using flexible nasoendoscopy. Conclusion In our experience Buccinator and FAMM musculo-mucosal flaps are an extremely versatile ‘like for like’ local flap option due to their long arc of rotation that we have used for the first time to successfully reconstruct the tongue base and lateral pharynx. As inset can be achieved via neck dissection access this avoids lip/jaw split as per conventional oropharyngeal surgical management further minimising morbidity.