The use of the facial artery musculomucosal flap for reconstruction of oral cavity defects after cancer resection

Background. Reconstruction of defects following surgery for head and neck cancer possess challenges for surgeons. The choice of the reconstruction option is determined by various factors, namely: the size and location of the defect, patients’ age, concomitant pathology, prognosis of the disease, and individual decisions of surgeons and patients. Microvascular surgery is a highly successful and relatively safe method for the reconstruction of large head and neck defects. However, the use of revascularized autografts is not possible in all categories of patients, and therefore the search for new reconstruction techniques is necessary to improve functional, aesthetic results and reduce trauma. Material and Methods. The use of different types of facial artery mucous-muscular (FAMM) flaps for the reconstruction of oral cavity defects after tumor resection was analyzed. From June 2020 to March 2021, 7 patients with histologically verified T2-4N0-1 oral cancer were treated at Blokhin National Medical Research Center of Oncology (Moscow). The patients underwent tumor resection with one-stage reconstruction using different types of FAMM flaps. All patients underwent adjuvant radiation therapy. Results. When cutting out the flap, an additional skin incision was not performed, the defect in the oral cavity was replaced by tissues of the same composition while preserving the small salivary glands, respectively, there was no hair growth and a defect in the donor bed. None of the cases had malnutrition of the flap. Conclusion. Good functional and cosmetic results in patients who underwent FAMM flap reconstruction may set a new standard in the replacement of small-to medium-size soft tissue defects in the oral cavity.