Anatomical basis and results of the facial artery musculomucosal flap for oral reconstruction

The facial artery musculomucosal (FAMM) flap is a newly designed buccal muc osal flap that was first described in 1992. The long rotational are of this flap is particularly suitable for anterior palatal defects that are otherw ise difficult to treat with local flaps. However, after the first clinical reports, some controversies arose about the reliability of this flap, so we conducted an anatomical study of the vascular pattern with a lates prepara tion in 10 cadavers. We studied the variations of the course of the facial artery and focused on the relationship between the facial artery and vein w ithin the pedicle. We concluded that the flap is more an arterialized flap than an axial-pattern flap, and have given anatomical landmarks to optimize the survival rate. Our preliminary clinical results (five good results, on e complete failure) are acceptable.