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Gur E, Tiftikcioglu YO. Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients. J Craniofac Surg 2023; 34:1335-1339. [PMID: 36872469 DOI: 10.1097/scs.0000000000009237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/05/2022] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION Defects of the palate can be as a result of oronasal fistula of cleft patients and the ablative surgery of tumors. There are many studies about reconstruction of the defects of plate in the literature and most of them are related to tumor surgery. Despite the use of free flaps in cleft patients being not a new approach, the articles in the literature are very few. The authors describe the experience of oronasal fistula reconstructions with free flaps with a new modification of tensionless inset of the free flap's pedicle. PATIENTS AND METHODS Between 2019 and 2022, 2 males and 1 female, 3 consecutive cleft patients underwent free flap surgery because of recalcitrant palatal defects. One patient had 5 and each of remain had 3 unsuccessful reconstructive attempts previously. The age of patients was ranged from 20 to 23 years old. Radial forearm flap was the option of oral lining reconstruction for all patients. In 2 patients, the flap was modified as a skin tail was linked to the flap for covering the pedicle as tensionless closure. RESULTS There was a mucosal swelling in first patient who underwent classical pedicle inset as mucosal tunneling. In 1 patient there was a spontaneous bleeding from the anterior side of the flap and it stopped without medical interventions, spontaneously. There was no additional complication. All flaps survived without anastomosis problems. CONCLUSION Incision of the mucosa rather than tunneling provides good surgical exposure and bleeding control and modified flap design may be beneficial and reliable for tensionless pedicle inset and covering.
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Affiliation(s)
- Ersin Gur
- Ege University Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Izmir, Turkey
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2
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Sandilands J, Somers M, Winters R. Intraoral flaps for oral cavity and oropharyngeal reconstruction. Curr Opin Otolaryngol Head Neck Surg 2023:00020840-990000000-00052. [PMID: 36942833 DOI: 10.1097/moo.0000000000000884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW Oral cavity reconstruction using local flaps is an area of head and neck surgery that has been overshadowed since the introduction of free flaps. Here, we discuss new developments, predominantly modifications to existing techniques for intraoral reconstruction, the utility of different local flaps and a review of functional outcomes. RECENT FINDINGS The facial artery musculomucosal (FAMM) flap has seen the greatest number of modifications to technique, most notably the extended double-pedicled, kite-shaped tunnelized and osseous myomucosal approaches. The tunnelled buccal fat pad flap has gained popularity as well as the use of combining two flaps such as the buccal fat pad and palatal island flap to reconstruct oral cavity defects with good effect. There is still a paucity of literature surrounding functional outcomes post reconstruction. Despite this, the complication rate for local flaps remains low. SUMMARY The value of intraoral flaps for oral cavity reconstruction is undisputed. However, they are potentially underutilised in the modern era of expanding availability and indications for free tissue transfer. As many practices see greater numbers of aging patients, often with multisystem comorbidities, local flaps are an important tool that can provide the surgeon with a greater number of reconstructive options.
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Affiliation(s)
| | | | - Ryan Winters
- Department of Otolaryngology, Head & Neck Surgery, John Hunter Hospital, New South Wales, Australia
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Buller M, Jodeh D, Qamar F, Wright JM, Halsey JN, Rottgers SA. Cleft Palate Fistula: A Review. EPLASTY 2023; 23:e7. [PMID: 36817364 PMCID: PMC9912053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Background The development of postoperative oronasal fistulae (ONF) is a complication that plagues all cleft surgeons to varying degrees. There is extensive literature discussing the incidence, functional impact, and treatment of ONF. The goal of this article is to provide an extensive review of the literature discussing the incidence, causative factors, functional impact, classification systems, and treatment of ONF. Methods A literature review was performed using PubMed using the Medical Subject Heading terms "cleft palate" AND "fistula" OR "palatal fistula" OR "oronasal fistula". After review, a total of 356 articles were deemed relevant for this study. Results Information regarding ONF care, prevention, and management in patients with cleft palate was collected from the articles included in this review. Treatment of ONF remains a challenging problem as there is not a consensus in the available literature on the best palatoplasty techniques for their prevention and treatment. A myriad of reconstructive options and adjunctive therapies exist, and their use is guided by the size and location of the fistula. Conclusions Fistula treatment should be tailored to the specific needs of the patient, and consideration must be given to not only the ONF itself but also the patient's stage of growth and development. Large-scale, multicenter studies are needed in which ONF are described using standardized nomenclature, and improved outcomes reporting is necessary to better define an algorithm for a truly holistic approach to palate surgery and reduce the incidence of palatal fistula.
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Affiliation(s)
- Mitchell Buller
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Jordan N Halsey
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - S Alex Rottgers
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
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Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap. J Clin Med 2022; 11:jcm11247458. [PMID: 36556074 PMCID: PMC9780850 DOI: 10.3390/jcm11247458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The aim of this study is to evaluate the functional outcomes and quality of life (QoL) in oncologic patients with intraoral defects reconstructed with the buccinator myomucosal flap. A retrospective study was performed involving 39 patients with intraoral soft-tissue defects, reconstructed with a buccinator myomucosal flap during a six-year period. Patients completed the European Organization for Research and Treatment of Cancer questionnaires, the standard questionnaire (QLQ-C30) and the head-and-neck specific module (QLQ-H&N35). Thirty-nine patients with a mean age of 61.23 ± 15.80 years were included in the study. Thirty-three patients were diagnosed with an oncological condition (84.61%). Six patients (15.38%) developed orosinusal communication and underwent extensive debridement. The median global-health-status score was 79.27 and emotional performance was the lowest scoring, with a mean score of 76.93. As for the symptom items, the most outstanding were dental problems (33.33), oral opening (31.62) and dry mouth (37.61), followed by sticky saliva (24.79), problems with social eating (21.15) and pain (19.87). The most significant symptoms were radiotherapy-related adverse effects such as pain, fatigue, dental problems and dry mouth. Patients reconstructed with the buccinator myomucosal flap develop a good quality of life for all types of activities, and a correct function and aesthetics. Postoperative radiotherapy is associated with a poorer quality of life, and can lead to impairment of several symptoms such as swallowing, oral opening and dry mouth.
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Rahpeyma A, Khajehahmadi S. Facial Artery Musculomucosal Flap in Alveolar Cleft Surgery. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:347-353. [PMID: 35223651 PMCID: PMC8829786 DOI: 10.22038/ijorl.2021.55381.2901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/26/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Large anterior palatal fistula and special alveolar clefts, such as edentulous atrophic premaxilla and absent premaxilla (premaxillectomy or agenesis), as well as wide unilateral alveolar cleft, are complicated cases in alveolar cleft bone grafting surgery. A superiorly-based buccinator myomucosal flap is suitable in this regard. MATERIALS AND METHODS The cleft patients whose large anterior palatal fistula and superiorly based buccinator myomucosal flap had been used for palatal or alveolar reconstruction were recruited in the study. The reconstruction method of the nasal floor, follow-up time, and hospital length of stay were recorded. RESULTS A total of 10 patients had been treated by this method. The majority of them were male (6/10), the age range of the patients was 14-25 years. All flaps survived and a case of partial necrosis occurred. CONCLUSION As evidenced by the obtained results, a superiorly-based facial artery musculomucosal flap is suitable when the palatal fistula is continuous with the alveolar cleft. Transmaxillary transfer is the other option in patients with closed maxillary arch.
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Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeedeh Khajehahmadi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Corresponding Author: Dental Research Center, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran. E-mail:
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Choi JM, Park H, Oh TS. Use of a buccinator myomucosal flap and bilateral pedicled buccal fat pad transfer in wide palatal fistula repair: a case report. Arch Craniofac Surg 2021; 22:209-213. [PMID: 34474545 PMCID: PMC8413924 DOI: 10.7181/acfs.2021.00269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/20/2021] [Indexed: 12/03/2022] Open
Abstract
Primary palatoplasty for cleft palate places patients at high risk for scarring, altered vascularity, and persistent tension. Palatal fistulas are a challenging complication of primary palatoplasty that typically form around the hard palate–soft palate junction. Repairing palatal fistulas, particularly wide fistulas, is extremely difficult because there are not many choices for closure. However, a few techniques are commonly used to close the remaining fistula after primary palatoplasty. Herein, we report the revision of a palatal fistula using a pedicled buccal fat pad and palatal lengthening with a buccinator myomucosal flap and sphincter pharyngoplasty to treat a patient with a wide palatal fistula. Tension-free closure of the palatal fistula was achieved, as well as velopharyngeal insufficiency (VPI) correction. This surgical method enhanced healing, minimized palatal contracture and shortening, and reduced the risk of infection. The palate healed with mucosalization at 2 weeks, and no complications were noted after 4 years of follow-up. Therefore, these flaps should be considered as an option for closure of large oronasal fistulas and VPI correction in young patients with wide palatal defects and VPI.
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Affiliation(s)
- Jin Mi Choi
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hojin Park
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Suk Oh
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Facial artery-based islanded myomucosal and bone flaps in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2020; 74:1269-1278. [PMID: 33257300 DOI: 10.1016/j.bjps.2020.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 08/25/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022]
Abstract
This article aims to illustrate various applications of facial artery-based islanded myomucosal (iFAMM) and osseous/osteo-myomucosal flaps (iFOMM) in head and neck reconstruction. A retrospective analysis of 75 patients who underwent the reconstruction of various head and neck mucosal defects with iFAMM/iFOMM in a tertiary head and neck cancer department from May 2015 to May 2019 was performed. The patients had surgery for cancer, which involved the oral tongue, floor of mouth, oropharynx, lower alveolus, larynx, hypopharynx, cricopharynx and trachea. iFOMM was used in 3 patients. Functional and esthetic outcomes, short-term and long-term complications were analyzed. The flap was successful in 74 out of 75 patients. Speech was intelligible in almost all patients and majority of patients could take oral feeds without any restrictions. The esthesis of reconstruction was scored high with a mean visual analog scale score of 8.4. The most commonly observed complication was marginal mandibular paresis, which improved with time. Mouth opening was >3 cm in 68/75 patients. Adjuvant radiation was a common factor in patients with <3 cm mouth opening. Flap was sensate by 4 months in majority of patients. The reach, pliability, and esthetics of the flap combined with recoverable morbidity of donor site present in the facial artery-based flap as a good option in the reconstruction of various head and neck subsites. Reduced operative time, lesser complication rates, less financial burden, and simplicity of the procedure make it a cost-effective alternate solution for reconstruction.
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Bauer HK, Flesch D, Walenta S, Unger RE, Schwab R, Nezi-Cahn S, Hasenburg A, Heller M, Brenner W. Primary Mucosal Epithelial Cell Cultivation: A Reliable and Accelerated Isolation. Tissue Eng Part C Methods 2019; 25:82-92. [DOI: 10.1089/ten.tec.2018.0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Heide-Katharina Bauer
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Daniela Flesch
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Urology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Walenta
- Institute of Pathophysiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ronald E. Unger
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Roxana Schwab
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Nezi-Cahn
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Annette Hasenburg
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Martin Heller
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Walburgis Brenner
- Department of Obstetrics and Women's Health, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- BiomaTiCS - Biomaterials, Tissues and Cells in Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Massarelli O, Vaira LA, Biglio A, Gobbi R, Piombino P, De Riu G. Rational and simplified nomenclature for buccinator myomucosal flaps. Oral Maxillofac Surg 2017; 21:453-459. [PMID: 28936552 DOI: 10.1007/s10006-017-0655-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/13/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reconstruction of moderate-sized mucosal defects of the oral cavity or oropharynx represents a surgical challenge. Buccinator myomucosal flaps seem to provide "ideal reconstruction" of oral/oropharyngeal defects because they carry a thin, mobile, well-vascularized, and sensitive tissue, like that excised or lost. Nevertheless, these flaps are not immediately popular because of confusion surrounding the complex terminology used to name them. METHODS After a retrospective study on our experience and a literature review, the authors propose a new rational and simplified nomenclature for the classification of buccinator myomucosal flaps, which clarifies the source vessel, the composition of the flap, and the type of transfer. RESULTS According to this nomenclature, six types of buccinator myomucosal flaps are described. CONCLUSIONS This proposed nomenclature may bring a consensus on the classification of buccinator myomucosal flaps and can help their spread.
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Affiliation(s)
- Olindo Massarelli
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Luigi Angelo Vaira
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy.
| | - Andrea Biglio
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Roberta Gobbi
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Pasquale Piombino
- Department of ENT, University of Campania "Luigi Vanvitelli" Hospital, Via Pansini 5, 08131, Naples, Italy
| | - Giacomo De Riu
- Department of Maxillofacial Surgery, Sassari University Hospital, Viale San Pietro 43B, 07100, Sassari, Italy
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Rahpeyma A, Khajehahmadi S. The posterior-based buccinator myomucosal flap (Bozola's flap). Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:293-294. [PMID: 28551010 DOI: 10.1016/j.anorl.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 01/23/2017] [Indexed: 10/19/2022]
Affiliation(s)
- A Rahpeyma
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Khajehahmadi
- Dental Research Center, Mashhad University of Medical Sciences, Vakilabad boulevard, Mashhad, Iran.
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Rahpeyma A, Khajehahmadi S. Donor site morbidity in buccinator-based myomucosal flaps: A retrospective study. Asian J Surg 2017; 40:210-214. [DOI: 10.1016/j.asjsur.2015.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/24/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022] Open
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Rahpeyma A, khajehahmadi S. Random Pattern Vertically Oriented, Partial Thickness Buccinator Myomucosal Flap for Intraoral Reconstruction:A Report of Two Cases. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2016; 28:227-31. [PMID: 27429953 PMCID: PMC4930847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Reconstruction of the oral cavity with a flap design containing the buccal mucosa and buccinator muscle but excluding the facial artery and vein is the topic of these case reports. CASE REPORTS This article uses random pattern vertically oriented partial thickness buccinator myomucosal flap for intraoral reconstruction in two cases. The first was for lining the mandibular anterior vestibule in a trauma patient. The second was for oral side coverage of bone graft in special cleft patient. In both patients, this flap survived and good bone coverage with non-keratinized mucosa was obtained. CONCLUSION Thin long buccal myomucosal flap not including facial artery and vein can survive.
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Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, Oral and Maxillofacial Surgery ,School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeedeh khajehahmadi
- Dental Research Center ,Oral and Maxillofacial Pathology , School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. ,Corresponding Author: Dental Research Center, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran. Tel: +98(51)38829501, E-mail:
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Facial Artery Musculomucosal (FAMM) flap for nasal lining in reconstruction of large full thickness lateral nasal defects. Ann Med Surg (Lond) 2015; 4:351-4. [PMID: 26566439 PMCID: PMC4600940 DOI: 10.1016/j.amsu.2015.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/07/2015] [Accepted: 08/21/2015] [Indexed: 11/30/2022] Open
Abstract
Obviously, restoring the nasal lining is a great challenge in the reconstruction of nasal defects. Full thickness nasal defects usually require special flaps for reconstructing the nasal lining. Intranasal mucosal flaps, hinge over flaps, perinasal second flaps, folded or second forehead flaps and finally free flaps are examples that can be used for this purpose. Moreover, the case presented in this article expresses a new role for the superiorly based Facial Artery Musculomucosal (FAMM) flap in this topic. Furthermore, mucosal island variant of this flap is presented to reduce the tension on this flap while restoring the nasal lining in large full thickness nasal defect. Full thickness nasal defects needs to nasal lining as well as outer skin coverage. FAMM flap is a useful flap in this topic for large defect. Length of FAMM flap is sufficient to reach the nasal cavity. Less mention in the literature as nasal lining. Minor donor site morbidity and appropriate paddle size are the other feature.
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Rahpeyma A, Khajehahmadi S. Pathologic Surface Changes in the Submental Flap Used for Intraoral Reconstruction: Report of Two Cases. J Clin Diagn Res 2015; 9:ZD01-3. [PMID: 26436060 PMCID: PMC4576654 DOI: 10.7860/jcdr/2015/12269.6267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 05/25/2015] [Indexed: 11/24/2022]
Abstract
Soft tissue reconstruction is often necessary after pathologic resection of oral squamous cell carcinoma. Although morphologic changes are common after transfer of the flaps to the oral cavity, pathologic changes within the transferred flaps, used for intraoral reconstruction, are rare events. Despite the widespread use of submental flap for oral cavity reconstruction, there are no reports in this respect. In this article, pathologic changes in the surface epithelium of transferred submental flaps are demonstrated with the report of two cases. The occurrence of lichen planus in a submental flap that had been used for reconstruction of lateral tongue border is reported in one case and in another patient, squamous cell carcinoma arising in the transferred de-epithelialized submental flap, used for maxillary and buccal reconstruction, is shown.
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Affiliation(s)
- Amin Rahpeyma
- Associate Professor, Department of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Assistant Professor, Department of Oral and Maxillofacial Pathology, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Head and Neck Reconstruction Using the Superiorly Based Reversed-Flow Facial Artery Myomucosal Flap. J Oral Maxillofac Surg 2015; 73:1008-15. [DOI: 10.1016/j.joms.2014.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 11/15/2014] [Accepted: 11/17/2014] [Indexed: 11/21/2022]
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Closure of huge palatal fistula in an adult patient with isolated cleft palate: a technical note. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e306. [PMID: 25750845 PMCID: PMC4350312 DOI: 10.1097/gox.0000000000000279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/05/2015] [Indexed: 11/26/2022]
Abstract
Closure of huge palatal fistula surrounded by fully erupted permanent dentition in the adult patients with cleft is a challenge. Posteriorly based buccinator myomucosal flap is a neurovascular pedicled flap, with inherent nature of thin thickness, saliva secretion, and axial pattern blood supply. Vicinity of donor site to the palate and low donor-site morbidity are the other advantages. It is an ideal choice in such situation. In this article, the details of surgical technique and the effectiveness of this method are presented.
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Combined Submental-tongue Flap for Reconstruction of Subtotal Traumatic Avulsion of Lower Lip: A Technical Note. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e302. [PMID: 25750841 PMCID: PMC4350308 DOI: 10.1097/gox.0000000000000273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Abstract
Delayed reconstruction of large lower lip defects after traumatic avulsion is a challenge in medically compromised patients with concomitant cheek skin burn. Combination of orthograde submental transposition flap and anteriorly based ventral rectangular myomucosal tongue flap is useful. The former reconstructs the body of the defect, and the latter masks the red lip, resembling vermilion. In this article, the detailed surgical technique is explained. Literature review of tongue flap and submental flap in the lower lip reconstruction is presented.
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Colletti G, Tewfik K, Bardazzi A, Allevi F, Chiapasco M, Mandalà M, Rabbiosi D. Regional Flaps in Head and Neck Reconstruction: A Reappraisal. J Oral Maxillofac Surg 2015; 73:571.e1-571.e10. [DOI: 10.1016/j.joms.2014.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/07/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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