Feasibility and Versatility of Facial and Maxillary Artery-based Flaps for Reconstruction of Oral Defects: Double-center Experience with a Standardized Assessment of Outcomes.

Reconstructing oral cavity defects poses significant challenges due to the variability in defect size and location following tumor resection. Myomucosal flaps provide reliable options for medium-sized defects with reduced donor site morbidity, satisfactory functional and aesthetic outcomes. A retrospective observational study was conducted on 46 patients treated between 2016 and 2022 in two head and neck oncological centers. Inclusion criteria were oral cancer diagnosis, medium-sized surgical defects, and suitability for myomucosal flap reconstruction. Functional outcomes, including tongue mobility, oral opening, and aesthetic satisfaction, were assessed using standardized tools: EORTC QLQ-HN35, PSS-HN, FACT H&N questionnaires, and VAS scores. All flaps were successfully harvested and transposed, with minimal complications. The mean defect size was 4.41 × 3.38 cm. Functional assessment showed a mean oral opening of 3.43 cm and satisfactory tongue mobility (mean score: 6.38). Aesthetic outcomes were rated positively (mean VAS: 7.11). Complications included flap edema (n = 2), marginal necrosis (n = 1), and neck infection (n = 1). Patients reconstructed with FAMMIF flaps exhibited slightly higher House-Brackmann scores. Overall, the questionnaires highlighted the feasibility and versatility of myomucosal flaps, despite inherent limitations in achieving pre-surgical functionality. Myomucosal flaps represent a versatile and reliable option for medium-sized oral defect reconstruction, balancing functional recovery with aesthetic satisfaction. Future studies should explore prospective comparisons with free flaps and focus on enhancing post-operative rehabilitation protocols.