Versatility of the facial artery myomucosal island flap in neopharyngeal reconstruction

Head Neck. 2017 Feb;39(2):E29-E33. doi: 10.1002/hed.24602. Epub 2016 Oct 5.

Abstract

Background: The facial artery myomucosal (FAMM) island flap is a cheek flap, pedicled on the facial artery and suitable for small to medium-sized reconstructions of the oral cavity and neighboring areas. A novel transposition of the flap to the hypopharynx after laryngectomy is presented in this report.

Methods: A 58-year-old man, previously irradiated, was laryngopharyngectomized because of a new supraglottic carcinoma. An unexpected need for a flap was solved by tunneling a FAMM island flap lateral to the mandible. The reach and size of the flap were sufficient to close the defect.

Results: Vitality of the flap was ascertained by fiber endoscopy. No donor-site morbidity was seen. Postoperatively, the patient had a minor stomal fistula with spontaneous healing.

Conclusion: The pedicled FAMM island flap may be considered for smaller reconstructions of the upper hypopharynx. Accessibility, low donor-site morbidity, and recipient tissue similarity count among the advantages. © 2016 Wiley Periodicals, Inc. Head Neck 39: E29-E33, 2017.

Keywords: facial artery myomucosal (FAMM); facial artery myomucosal island flap; hypopharynx; pedicled flap; pharyngolaryngectomy.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Facial Muscles / blood supply
  • Facial Muscles / transplantation*
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Neck Dissection / methods
  • Pharyngectomy / methods
  • Plastic Surgery Procedures / methods*
  • Positron Emission Tomography Computed Tomography / methods
  • Quality of Life
  • Radiotherapy, Adjuvant
  • Risk Assessment
  • Surgical Flaps / blood supply
  • Surgical Flaps / transplantation*
  • Treatment Outcome
  • Wound Healing / physiology