Facial Artery Mucosa Muscular Flap: Possible after Oral Chemoradiotherapy

Abstract

Objective: The Facial Artery Mucosa Muscular (FAMM) Flap, described by Pribaz in 1992, can be used in oral surgery on different indications. The primary reconstruction after the resection for an oral cancer is the most evaluated indication. Method: Thirty-five cases from the University Hospital of Brest Head and Neck Surgery Center between April 2007 and November 2010 were analyzed in a retrospective study. The indication, the status of treatment (post chemoradiotherapy or not), complications (hematoma, infection, necrosis), the weaning delay of the pedicula, and time to an oral feeding were all analyzed. Results: Twelve cases for primary reconstruction, 7 cases for buccosinusis defect and 16 cases in osteoradionecrosis. One case of hematoma, no infection and no necrosis were observed. One case did not give a good result. There is no difference in terms of viability between postchemoradiotherapy surgery. The weaning delay and the time delay to an oral feeding is twice longer after radiotherapy. Conclusion: This flap can be used after radiotherapy with a precaution of care. The FAMM flap represents a good solution event after chemoradiotherapy for the loss of medium size substance, it represents a good solution between directed healing and more consistent skin flaps.