Sep 10, 2013 - 7:46 am
J Plast Reconstr Aesthet Surg. 2013 Oct;66(10):1365-8. doi: 10.1016/j.bjps.2013.05.029. Epub 2013 Jun 10.
A novel use of the facial artery based buccinator musculo-mucosal island flap for reconstruction of the oropharynx.
Head & Neck Unit, Oxford University Hospitals NHS Trust, Oxford, UK. Electronic address: firstname.lastname@example.org.
These are my surgeons at the Churchill Hospital I must have been one of their guinea pigs
The buccinator musculo-mucosal island or Zhao flap can be used to reconstruct a wide range of intra-oral defects
including floor of mouth, tonsillar fossa and lateral tongue. We describe our experience with the inferiorly based facial
artery buccinator musculo-mucosal flap for a novel use in the reconstruction of oropharyngeal tumours at the tongue
base and lateral pharyngeal wall. We prospectively reviewed all patients who underwent buccinator musculo-mucosal
island flap reconstruction examining indication, operative details, and post-operative outcomes. We describe our
technique for its novel use in lateral pharynx/tongue base reconstruction through neck dissection access. Deeper flaps
were adequately visualised and monitored using flexible nasoendoscopy. There were no flap failures with all patients
achieving primary healing with minimal complications. All donor sites closed directly with minimal scarring. Two
patients reported mild tightness on mouth opening and two patients reported transient weakness of the mandibular
branch of the facial nerve. In our experience the buccinator musculo-mucosal island flap is an extremely versatile 'like
for like' local flap option due to its long arc of rotation. As inset can be achieved via neck dissection access, this avoids
lip/jaw split as per conventional oropharyngeal surgical management further minimising morbidity. We present the
first series of its effective use in oropharyngeal reconstruction.
Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All
Buccinator musculo-mucosal flap, FAMM flap, Facial artery musculo-mucosal flap, Oropharynx, Zhao flap