TÁI TẠO KHUYẾT HỔNG BẰNG VẠT ĐẢO CƠ NIÊM MẠC MÁ TRONG PHẪU THUẬT CẮT UNG THƯ KHOANG MIỆNG

Abstract

Introduction: The island facial artery myomucosal (i-FAMM) flap, based on the facial artery, has emerged as a favorable option for oral cavity rescontruction due to its high mobility, capacity to reach distant defects, and potential for early functional recovery. Objectives: To describe the surgical technique and evaluate the early outcomes of using the i-FAMM flap for one-staged reconstruction of oral cavity defects following cancer resection. Patients and methods: A prospective, non-controlled interventional study was conducted on 33 patients undergoing oral cavity cancer surgery with immediate defect reconstructions using the i-FAMM flap at the Department of Otorhinolaryngology – Cho Ray Hospital from January 2020 to January 2024. Results: The most commonly affected primary tumor site was the tongue, with or without floor of mouth involvement (25/33 cases). Tumor stages included T2NxM0 (26/33) and T3NxM0 (7/33). The mean flap size was 3.0 cm (range: 2.9-3.1 cm) x 5.4 cm (range: 5.2-5.5 cm). All flaps survived, and all patients resumed oral intake by postoperative day 7. Oral function was fully restored, donor sites healed well, and no local recurrence or cervical lymph node metastasis was noted during the 6-month follow-up. Complications included: distal flap necrosis (1 case), wound dehiscene (3 cases), slight mouth opening limitation (1 case), and mandibular nerve weakness (2 cases, recovered after 6 months). Conclusions: The i-FAMM flap demonstrates excellent mobility, reliable vascularity, short harvesting time, and a high success rate for one-stage reconstruction of intraoral defects following tumor resection.