Intraoral flaps for oral cavity and oropharyngeal reconstruction

Abstract

Purpose of review Oral cavity reconstruction using local flaps is an area of head and neck surgery that has been overshadowed since the introduction of free flaps. Here, we discuss new developments, predominantly modifications to existing techniques for intraoral reconstruction, the utility of different local flaps and a review of functional outcomes. Recent findings The facial artery musculomucosal (FAMM) flap has seen the greatest number of modifications to technique, most notably the extended double-pedicled, kite-shaped tunnelized and osseous myomucosal approaches. The tunnelled buccal fat pad flap has gained popularity as well as the use of combining two flaps such as the buccal fat pad and palatal island flap to reconstruct oral cavity defects with good effect. There is still a paucity of literature surrounding functional outcomes post reconstruction. Despite this, the complication rate for local flaps remains low. Summary The value of intraoral flaps for oral cavity reconstruction is undisputed. However, they are potentially underutilised in the modern era of expanding availability and indications for free tissue transfer. As many practices see greater numbers of aging patients, often with multisystem comorbidities, local flaps are an important tool that can provide the surgeon with a greater number of reconstructive options.

Single-Stage Peninsular-Shaped Lateral Tongue Flap for Personalized Reconstruction of Various Small- to Moderate-Sized Intraoral Defects: A Retrospective Case Series with Tongue Function Evaluation Using the Functional Intraoral Glasgow Scale

“…Furthermore, it is imperative to recognize that free flap surgery may be contraindicated in cases where patients are unable to endure prolonged operative times due to underlying comorbidities, such as cardiopulmonary conditions, cardiac issues, or impaired renal function [2,3,10]. In such instances, when feasible, local flap techniques may present a suitable alternative, particularly for small-to moderate-sized intraoral defects [1][2][3][4][5][11][12][13][14][15][16][17]. In a previous study, we reported a successful case involving the use of a single-stage peninsular-shaped lateral tongue flap (pLTF) for reconstructing an intraoral defect following tumor resection in the buccal area, which encompassed the retromolar trigone (RMT) region [2].…”