Patient Satisfaction After Using a Reverse Flow Based Facial Artery Musculomucosal Flap (FAMM) versus a Palatal Pedicled Flap for Closure of Recurrent Small and Medium-Sized Oronasal Fistula: A Randomized Clinical Trial

Abstract

Objectives: To evaluate the clinical success and patient satisfaction of FAMM for closure of recurrent small to medium oronasal fistula in comparison to the palatal pedicle flap.Patients and Methods: 24 patients with recurrent small and medium-sized oronasal fistula failed after several trials to close, up to 10 mm were recruited. Patients were equally divided into two groups; G1: had surgical closure using FAMM flap and G2: had a Palatal Pedicle flap. Success is determined by the degree of patient satisfaction and healing, as well as the lack of complications.Results: Clinical results showed that in the 2 nd and 4 th week, the percentage of healed fistula was 100% in the FAMM group and 75% in the palatal flap group while in the 2 nd and 3 rd month, the percentage of patients with healed fistula was 100% in FAMM and 75% in the palatal flap groups. Regarding mouth opening results showed that at the 2 nd and 4 th week, the percentage of patients with normal oral competency was 91.7% in the FAMM group, compared to 75% in the palatal flap group while at the 2 nd and 3 rd month the percentage of patients with normal oral competency was 100% in the FAMM group compared to 75% in the palatal flap group with no statistically significant differences. Conclusion:The FAMM flap and palatal pedicle flap are effective choices for reconstructing small to medium-sized recurrent ONF due to their reliability and versatility. Both flaps yield satisfactory functional outcomes. Truly, FAMM flap is preferred over palatal flap.