Role of Facial Artery Musculomucosal Flap in Large and Recurrent Palatal Fistulae

Shetty, Rahul; Lamba, Shashank; Gupta, Ashish Kumar

doi:10.1597/12-115

Cited by 30 publications

(20 citation statements)

References 17 publications

(18 reference statements)

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“…Only the longest flap of 15 × 70 mm failed, as complete necrosis [11]. In another report by Shetty et al [17], an anterior fistula following dental cyst excision, which measured 1.2 cm 2 , was successfully closed with a superiorly-based FAMM flap. In contrast, our patient had intractable OAF with chronic infection following dental extraction that was previously closed with a palatal flap, unsuccessfully.…”

Section: Discussionmentioning

confidence: 99%

Facial artery musculomucosal flap to close an oroantral fistula

Ohtsuki

Akashi

Hashikawa

et al. 2018

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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Oroantral fistulas (OAF), which develop as a result of maxillary sinus infection caused by oroantral communication, are sometimes intractable. We present a case of closure with a facial artery musculomucosal flap (FAMM flap) for intractable OAF. A 73-year-old man presenting with an OAF and rhinorrhea was referred to our department. Twenty-eight years earlier, he had undergone bilateral radical surgery for maxillary sinusitis, and six years earlier, he underwent extraction of his right maxillary first and second molars. Six months after the dental extractions, he developed maxillary sinusitis secondary to oroantral communication. Four years after the dental extractions, he underwent endoscopic sinus surgery with closure of the OAF with a rotational pedicled palatal flap, but the OAF recurred. To treat the OAF recurrence, we used a FAMM flap. His postoperative course was good, with no OAF recurrence 6 years after surgery. FAMM flaps are useful to close intractable OAFs.

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Section: Discussionmentioning

confidence: 99%

Facial artery musculomucosal flap to close an oroantral fistula

Ohtsuki

Akashi

Hashikawa

et al. 2018

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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“…Zhang et al (2014) reported a higher rate of recurrence, 18% (4/22) when using the buccal flap for both primary and secondary palate fistula closures. Shetty et al (2013) conducted a retrospective analysis on FAMM flaps and reported no fistula recurrences (0/11) after fistula repair, suggesting that FAMM flaps are a reliable flap for larger, complicated defects. While these results are encouraging, future studies comparing outcomes of buccal and FAMM flaps by fistula size and location may improve the flap selection process.…”

Section: Discussionmentioning

confidence: 99%

A Toolbox of Surgical Techniques for Palatal Fistula Repair

Rothermel

Lundberg

Samson

et al. 2020

The Cleft Palate-Craniofacial Journal

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Objective: To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. Design: A 4-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) development of a schema for fistula management using transcripts of the in-person case discussion, (3) evaluation of the preliminary schema via a web-based survey of additional cleft surgeons, and (4) revision of the management schema using survey responses. Participants: Six cleft surgeons participated in the in-person case discussion. Eleven additional surgeons participated in the web-based survey. Participants had diverse training experiences, having completed residency and fellowship at 20 different hospitals. Results: A schema for fistula management was developed, organized by fistula location. The schema catalogues all viable approaches for each location. For fistulae involving the soft palate, the schema stresses the importance of evaluating for velopharyngeal insufficiency (VPI) and incorporating VPI management into fistula repair. For fistulae involving the hard palate, the schema separately enumerates the techniques available for nasal lining repair and for oral lining repair in each region. The schema also catalogues the diversity of approaches to lingual- and labioalveolar fistula, including variation in timing, orthodontic preparation, and simultaneous alveolar bone grafting. Conclusions: This study employed consensus methods to create a comprehensive inventory of available fistula repair techniques and to identify preferential techniques among a diverse group of surgeons.

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“…Alternatively, enoral myomucosal local axial flaps such as the Bozola flap, based on the buccal artery, or in case of medium‐sized defects the facial artery musculomucosal flap, commissure based buccal musculomucosal flap, and dorsally based buccal musculomucosal flap can be employed. The latter flaps have the advantage not to require facial artery dissection for similar flap sizes.…”

Section: Discussionmentioning

confidence: 99%

Intraoral anastomosis of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate

et al. 2013

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In this report, we present a case of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate with transoral single arterial and three venous anastomoses. A 17-years-old female patient presented a large cleft palate defect and complete dentition, dysmelia of both arms and bilateral thumb aplasia. A radial flap was prelaminated using oral mucosa 5 days prior to transplantation. Five days after flap prelamination, the facial artery and vein, submandibular vein, and a venous branch to the masseter muscle behind the buccinator muscle fibers were exposed through an intraoral incision lateral to the inferior right mucogingival junction. The radial artery, its bilateral accompanying veins, and the cephalic vein of transplanted flap were anastomosed transorally to the facial vessels, submandibular vein, and masseter branch. The vessel pedicle ran through the palatoglossal arch dorsal to the second upper molar. Good flow and flap perfusion were evinced, and further-on successful healing was achieved. The case encourages similar treatment in comparable situations avoiding facial nerve hazard and extraoral scars.

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Role of Facial Artery Musculomucosal Flap in Large and Recurrent Palatal Fistulae

Cited by 30 publications

References 17 publications

Facial artery musculomucosal flap to close an oroantral fistula

Facial artery musculomucosal flap to close an oroantral fistula

A Toolbox of Surgical Techniques for Palatal Fistula Repair

Intraoral anastomosis of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate

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