Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Tunnelized-facial Artery Myomucosal Island Flap (t-FAMMIF) for Palatomaxillary Reconstruction: A Report of Two Cases

터널화 안면동맥 협부 근점막 도피판을 이용한 구개상악 결손의 재건: 증례보고

  • Ryu, Da Jung (Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital) ;
  • Jang, Hyo Won (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Park, Hye Jeong (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Kim, Hyung Jun (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Cha, In-Ho (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Nam, Woong (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry)
  • 류다정 (강남세브란스 치과병원 구강악안면외과) ;
  • 장효원 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 박혜정 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 김형준 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 차인호 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 남웅 (연세대학교 치과대학 구강악안면외과학교실)
  • Received : 2012.11.12
  • Accepted : 2013.03.19
  • Published : 2013.03.31
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Abstract

There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

Keywords

References

  1. Rogers SN, Lowe D, McNally D, Brown JS, Vaughan ED. Health-related quality of life after maxillectomy: a comparison between prosthetic obturation and free flap. J Oral Maxillofac Surg 2003;61:174-81. https://doi.org/10.1053/joms.2003.50044
  2. Elsherbiny M, Mebed A, Mebed H. Microvascular radial forearm fasciocutaneous free flap for palatomaxillary reconstruction following malignant tumor resection. J Egypt Natl Canc Inst 2008;20:90-7.
  3. Lee MC, Lee DW, Rah DK, Lee WJ. Reconstruction of a total soft palatal defect using a folded radial forearm free flap and palmaris longus tendon sling. Arch Plast Surg 2012;39:25-30. https://doi.org/10.5999/aps.2012.39.1.25
  4. Zhao Z, Li S, Yan Y, et al. New buccinator myomucosal island flap: anatomic study and clinical application. Plast Reconstr Surg 1999;104:55-64. https://doi.org/10.1097/00006534-199907000-00008
  5. Zhao Z, Zhang Z, Li Y, et al. The buccinator musculomucosal island flap for partial tongue reconstruction. J Am Coll Surg 2003;196:753-60. https://doi.org/10.1016/S1072-7515(03)00100-5
  6. Massarelli O, Baj A, Gobbi R, et al. Cheek mucosa: A versatile donor site of myomucosal flaps. Technical and functional considerations. Head Neck 2013;35:109-17. https://doi.org/10.1002/hed.22933
  7. Massarelli O, Gobbi R, Soma D, Tullio A. The folded tunnelized-facial artery myomucosal island flap: a new technique for total soft palate reconstruction. J Oral Maxillofac Surg 2013;71:192-8. https://doi.org/10.1016/j.joms.2012.03.030
  8. Anastassov GE, Schwartz S, Rodriguez E. Buccinator myomucosal island flap for postablative maxillofacial reconstructions: a report of 4 cases. J Oral Maxillofac Surg 2002;60:816-21. https://doi.org/10.1053/joms.2002.33252
  9. Rieger J, Bohle Iii G, Huryn J, Tang JL, Harris J, Seikaly H. Surgical reconstruction versus prosthetic obturation of extensive soft palate defects: a comparison of speech outcomes. Int J Prosthodont 2009;22:566-72.
  10. Seikaly H, Rieger J, Zalmanowitz J, et al. Functional soft palate reconstruction: a comprehensive surgical approach. Head Neck 2008;30:1615-23. https://doi.org/10.1002/hed.20919
  11. Kim JH, Chu HR, Kang JM, et al. Functional benefit after modification of radial forearm free flap for soft palate reconstruction. Clin Exp Otorhinolaryngol 2008;1:161-5. https://doi.org/10.3342/ceo.2008.1.3.161
  12. Hirsch DL, Howell KL, Levine JP. A novel approach to palatomaxillary reconstruction: use of radial forearm free tissue transfer combined with zygomaticus implants. J Oral Maxillofac Surg 2009;67:2466-72. https://doi.org/10.1016/j.joms.2009.04.062
  13. Bozola AR, Gasques JA, Carriquiry CE, Cardoso de Oliveira M. The buccinator musculomucosal flap: anatomic study and clinical application. Plast Reconstr Surg 1989;84:250-7. https://doi.org/10.1097/00006534-198908000-00010
  14. Bianchi B, Ferri A, Ferrari S, Copelli C, Sesenna E. Myomucosal cheek flaps: applications in intraoral reconstruction using three different techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:353-9. https://doi.org/10.1016/j.tripleo.2009.04.021
  15. Carstens MH, Stofman GM, Hurwitz DJ, Futrell JW, Patterson GT, Sotereanos GC. The buccinator myomucosal island pedicle flap: anatomic study and case report. Plast Reconstr Surg 1991;88:39-50. https://doi.org/10.1097/00006534-199107000-00007
  16. Ferrari S, Ferri A, Bianchi B, Copelli C, Magri AS, Sesenna E. A novel technique for cheek mucosa defect reconstruction using a pedicled buccal fat pad and buccinator myomucosal island flap. Oral Oncol 2009;45:59-62. https://doi.org/10.1016/j.oraloncology.2008.03.018
  17. Ferrari S, Ferri A, Bianchi B, Copelli C, Sesenna E. Reconstructing large palate defects: the double buccinator myomucosal island flap. J Oral Maxillofac Surg 2010;68:924-6. https://doi.org/10.1016/j.joms.2009.08.009
  18. Szeto C, Yoo J, Busato GM, Franklin J, Fung K, Nichols A. The buccinator flap: a review of current clinical applications. Curr Opin Otolaryngol Head Neck Surg 2011;19:257-62. https://doi.org/10.1097/MOO.0b013e328347f861
  19. Ferrari S, Ferri A, Bianchi B, Copelli C, Boni P, Sesenna E. Donor site morbidity using the buccinator myomucosal island flap. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:306-11. https://doi.org/10.1016/j.tripleo.2010.05.051