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Facial artery musculomucosal flap to oropharyngeal defect

Posts: 498
Joined: Aug 2013
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: khurram.khan@ouh.nhs.uk.

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

rights reserved.


Buccinator musculo-mucosal flap, FAMM flap, Facial artery musculo-mucosal flap, Oropharynx, Zhao flap





[PubMed - in process]
Grandmax4's picture
Posts: 708
Joined: Dec 2011

I love reading about modern technology and the improvments of  treatments, I was sorta a guinea pig too when my surgeon used the di vinci robot to remove my epiglottis..please everyone continue to give to the Cancer Society , maybe someday this beast will be slain for all

Posts: 498
Joined: Aug 2013

I had this op where they construct a flap from the inside cheek. It took straight away and I was talking, swallowing, eating within 2 weeks. At first pureed food but now I can eat proper meals. Yesterday ( 8 weeks later) I had a green bean and lamb and tomato casserole with sweet mashed potato. Today I had a quickie tea, baked beans on toast with 2 poached eggs on top.  I have two little grumbles, I have started to bite my inside mouth towards the back teeth, a piece of the cheek has started to get between my teeth if I'm not careful, also my mouth is weak one side. I went to my doc today he suggested getting a shield made to wear at night in bed so I dont bite myself and after the rad he will get me an appointment for a bit of cosmetic work, for the mouth if it doesn't strengthen. Dr Potter who did the  surgery to the tongue  said it should be hardly noticable in 6 months. He's a cosmetic surgeon. The neck dissection was done by Dr Silva (both mentioned doing the research above). I'm lucky as this was  done by the National Health Service free, all my medical procedures are free, dentist, docs prescriptions etc. I'm a senior so I dont pay for prescriptions any more. For younger people they are about £8 a prescription but the hospitals etc are free.  If I lived in the states I wouldn't be able to afford insurance, one of the reasons I dont stay more than a month with my sister in Florida, she'd love me to move there.

Posts: 7
Joined: Oct 2009

I'm glad to hear you've had a good experience with this surgery.  I am having it done myself in a couple of weeks.  I have two failed attempts at local flaps from my palate and I'm hoping this third surgery is a sucess. 

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