Feasibility and Versatility of Facial and Maxillary Artery-based Flaps for Reconstruction of Oral Defects: Double-center Experience with a Standardized Assessment of Outcomes
摘要
Reconstructing oral cavity defects poses significant challenges due to the variability in defect size and location following tumor resection. Myomucosal flaps provide reliable options for medium-sized defects with reduced donor site morbidity, satisfactory functional and aesthetic outcomes. A retrospective observational study was conducted on 46 patients treated between 2016 and 2022 in two head and neck oncological centers. Inclusion criteria were oral cancer diagnosis, medium-sized surgical defects, and suitability for myomucosal flap reconstruction. Functional outcomes, including tongue mobility, oral opening, and aesthetic satisfaction, were assessed using standardized tools: EORTC QLQ-HN35, PSS-HN, FACT H&N questionnaires, and VAS scores. All flaps were successfully harvested and transposed, with minimal complications. The mean defect size was 4.41 × 3.38 cm. Functional assessment showed a mean oral opening of 3.43 cm and satisfactory tongue mobility (mean score: 6.38). Aesthetic outcomes were rated positively (mean VAS: 7.11). Complications included flap edema (n = 2), marginal necrosis (n = 1), and neck infection (n = 1). Patients reconstructed with FAMMIF flaps exhibited slightly higher House-Brackmann scores. Overall, the questionnaires highlighted the feasibility and versatility of myomucosal flaps, despite inherent limitations in achieving pre-surgical functionality. Myomucosal flaps represent a versatile and reliable option for medium-sized oral defect reconstruction, balancing functional recovery with aesthetic satisfaction. Future studies should explore prospective comparisons with free flaps and focus on enhancing post-operative rehabilitation protocols.