Myomucosal island flaps for oropharyngeal reconstruction - 08/08/24

Doi : 10.1016/j.anorl.2023.11.015

C. Carnevale ^a,^b,^⁎ , G. Til Pérez ^a,^b, P. Sarría Echegaray ^a,^b, C. Morales Olavarría ^c
^a Department of Otorhinolaryngology Head and Neck Surgery, Clínica Rotger, Quirón Salud, Palma de Mallorca, Spain
^b University of the Balearic Island, Palma de Mallorca, Spain
^c Department of Otorhinlaryngology Head and Neck Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain

^⁎Corresponding author at: Department of Otolaryngology Head and Neck, Clínica Rotger, Quirón Salud, Palma de Mallorca, Spain.Department of Otolaryngology Head and Neck, Clínica Rotger, Quirón SaludPalma de MallorcaSpain

Abstract

The oropharynx represents one of the most challenging areas to reconstruct for the head and neck surgeon. The buccinator myomucosal island flaps pedicled on the facial artery [tunnelized facial artery myomucosal island flap (t-FAMMIF)] or the buccal artery [buccal artery myomucosal island flap (BAMMIF)] are an ideal reconstructive option for moderate size defects measuring up to 8–9cm. Two fresh specimens have been used to show the step-by-step surgical technique of both island flaps. Design and flap extension, dissection plane, identification of the vascular pedicle, flap rotation and insetting are described. Reconstructive indications and the pros and cons of each one are discussed in this article. Myomucosal island flaps represent a very useful and versatile option for the functional reconstruction of the oropharynx. A detailed knowledge of the vascular anatomy of the cheek is key to obtain a large flap while minimizing the risk of complications.

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Keywords : Oropharyngeal reconstruction, Oropharyngeal cancer, Buccinator myomucosal flap, Facial artery musculomucosal flap, Soft palate reconstruction