The facial artery musculomucosal flap: Modification of the harvesting technique for a single-stage procedure

Abstract

INTRODUCTION The facial artery musculomucosal (FAMM) flap was first described in 1992 by Pribaz et al. This flap allows reconstruction of smallto medium-size oral cavity, oropharynx, and intranasal defects. Lateral and anterior floor-of-mouth (FOM) defects have been successfully reconstructed with the FAMM flap, maintaining the tongue mobility and ensuring adequate elocution and the oral phase of deglutition. The FAMM flap can also be used for reconstructions of other subsites of the oral cavity as well as the lip and vermillion reconstruction. However, a second-stage procedure is often needed to reduce the bulky mucosal paddle at the base of the flap, to increase the depth of the vestibule and to allow greater mobility of the mobile tongue. A second-stage procedure is required in approximately one third of the patients. We present herein a modification of the surgical approach of the FAMM flap to allow a one-stage procedure and the surgical outcomes in three cases.