The outcomes of Facial Artery Musculomucosal (FAMM) flaps in oral oncologic reconstructions.

Abstract

Introduction: Head and neck cancer ablation results in challenging defects with complex reconstructive needs. The type of reconstruction depends on the nature, site, and size of the defect. Facial artery Musculomucosal (FAMM) flap reconstruction has emerged as a versatile option in a variety of small and medium-sized oral and oropharyngeal defects. We describe our experience reconstructing 12 intraoral defects with FAMM flap following resection for benign or malignant disease, with some having their surgery during the early Covid 19 pandemic.

Materials and methods: We examined patient demographics, diagnosis, site, TNM staging, type of FAMM flap, associated functional/cosmetic outcomes, oncological resection margins and adjuvant treatment.

Results: Most patients (75%) had Squamous cell carcinoma, with the palate (41.6%) being the most common site. Inferiorly based FAMM flaps (91.7%) were used in the majority. Clinically, T1 and T2 tumours (91.7%) were the most common. 91.7% had resumed normal dietary function; 83.4% had fully intelligible speech as assessed by the speech and language therapist; and 91.7% had aesthetically pleasing outcomes. 81.8% had clear resection margins. Two patients developed small residual oroantral fistulae requiring repair.

Conclusion: The FAMM flap is a reliable option for reconstructing small to medium-sized oral defects with several advantages and excellent functional and cosmetic outcomes.