Islanded facial artery musculomucosal flap for tongue reconstruction

We read with great interest the technical note by Joseph et al.1, concerning the use of a "technical modification to the FAMM flap" in order to reconstruct a post-ablative lingual side defect. This modification consists in the harvest of a buccinator myomucosal island flap pedicled on the facial vessels. The flap is then carried in the neck through a paramandibular passage and finally brought back into the oral cavity through a lingual tunnel. This modification allows the flap's arc of rotation to be increased and avoids secondary pedicle section.

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