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Facial Artery Musculomucosal Flap for Reconstruction of Partial Glossectomy Defects
Kristen Aliano, MD1, John Layliev, MD2, Steve Stavrides, PA-C1, Tommaso Addona, MD1, Matthew Kilgo, MD1, Douglas Frank, MD2, Thomas Davenport, MD1.
1Long Island Plastic Surgical Group, Garden City, NY, USA, 2North Shore-LIJ Health System, New Hyde Park, NY, USA.

BACKGROUND:Reconstruction of partial glossectomy defects secondary to tumor excision has always been challenging because of the complexity of tongue function. Small to medium-sized glossal defects are often repaired with primary closure or with bulkier free flaps. However, these methods of reconstruction can lead to tethering and poor tongue mobility. We present use of the using the facial artery myomucosal (FAMM) flap for partial glossectomy defects. We propose the use of the FAMM flap for improved tongue function in the setting where the defect is too large for primary closure, but where free tissue transfer would provide coverage where the volume of the flap would interfere with tongue function.
METHODS:We conducted a retrospective chart analysis of twenty-three patients who underwent partial glossectomy with FAMM flap reconstruction over a 27 month period. We examined tumor type and location, along with post-operative complications, functional outcomes, and need for further procedures. RESULTS:
Of the 23 patients, all flaps provided adequate coverage and there were no flap failures, although there was one take-back for reinset. All patients had adequate swallow studies with no aspiration and all patients had acceptable speech post-operatively.CONCLUSIONS:
The FAMM flap provides a good alternative to primary closure and split-thickness skin grafting for patients with small and medium-sized tongue defects after glossectomy. The flap is close in proximity to the defect, is of similar tissue composition, and produces good functional outcome.


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