Reconstruction of medium-size defects of the oral cavity: radial forearm free flap vs facial artery musculo-mucosal flap.


Journal

Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
ISSN: 1916-0216
Titre abrégé: J Otolaryngol Head Neck Surg
Pays: England
ID NLM: 101479544

Informations de publication

Date de publication:
03 Dec 2021
Historique:
received: 31 01 2020
accepted: 24 05 2021
entrez: 4 12 2021
pubmed: 5 12 2021
medline: 15 12 2021
Statut: epublish

Résumé

The radial forearm free flap (RFFF) is the most commonly used flap for defects of the oral cavity. The facial artery musculomucosal (FAMM) is a safe and effective method to reconstruct medium sized defects of the oral cavity. No comparison exists between the FAMM flap and RFFF. 1) Retrospective chart review from 2007 to 2016. 2) Cost difference analysis. Thirteen FAMM flap cases and 18 RFFF met inclusion criteria. The FAMM flap showed a tendency to lower rates of return to the operating room (p = 0.065) as well as lower rates of complications not requiring return to the OR with 1 complication in 1 patient as opposed to 10 patients with 15 complications (p = 0.008). Also, FAMM flap had shorter operative times compared to the RFFF group (7.2HR and 8.9 HR respectively, p = 0.002). The average operative room related costs for a FAMM flap were 6510 CAD vs 10,703 CAD for RFFF (p < 0.0005). Speech and swallowing outcomes were similar (p > 0.05). The FAMM flap can be used for reconstruction of medium-size defects of the oral cavity with functional outcomes similar to the RFFF while decreasing the associated costs and morbidity.

Sections du résumé

BACKGROUND BACKGROUND
The radial forearm free flap (RFFF) is the most commonly used flap for defects of the oral cavity. The facial artery musculomucosal (FAMM) is a safe and effective method to reconstruct medium sized defects of the oral cavity. No comparison exists between the FAMM flap and RFFF.
METHODS METHODS
1) Retrospective chart review from 2007 to 2016. 2) Cost difference analysis.
RESULTS RESULTS
Thirteen FAMM flap cases and 18 RFFF met inclusion criteria. The FAMM flap showed a tendency to lower rates of return to the operating room (p = 0.065) as well as lower rates of complications not requiring return to the OR with 1 complication in 1 patient as opposed to 10 patients with 15 complications (p = 0.008). Also, FAMM flap had shorter operative times compared to the RFFF group (7.2HR and 8.9 HR respectively, p = 0.002). The average operative room related costs for a FAMM flap were 6510 CAD vs 10,703 CAD for RFFF (p < 0.0005). Speech and swallowing outcomes were similar (p > 0.05).
CONCLUSION CONCLUSIONS
The FAMM flap can be used for reconstruction of medium-size defects of the oral cavity with functional outcomes similar to the RFFF while decreasing the associated costs and morbidity.

Identifiants

pubmed: 34861896
doi: 10.1186/s40463-021-00523-z
pii: 10.1186/s40463-021-00523-z
pmc: PMC8643000
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

67

Informations de copyright

© 2021. The Author(s).

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Auteurs

Badr Ibrahim (B)

Division of Otolaryngology-Head & neck Surgery, Université de Montréal, Hôpital Sacré Coeur de Montréal, Montreal, Canada.
Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Canada.

Akram Rahal (A)

Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Canada.
Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l'Université de Montréal, 1000 Saint-Denis St, Montreal, QC, H2X 0C1, Canada.

Eric Bissada (E)

Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l'Université de Montréal, 1000 Saint-Denis St, Montreal, QC, H2X 0C1, Canada.

Apostolos Christopoulos (A)

Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l'Université de Montréal, 1000 Saint-Denis St, Montreal, QC, H2X 0C1, Canada.

Louis Guertin (L)

Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l'Université de Montréal, 1000 Saint-Denis St, Montreal, QC, H2X 0C1, Canada.

Tareck Ayad (T)

Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Canada. tareck.ayad@umontreal.ca.
Division of Otolaryngology-Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l'Université de Montréal, 1000 Saint-Denis St, Montreal, QC, H2X 0C1, Canada. tareck.ayad@umontreal.ca.

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