FAMM flap in oral cavity and tongue defect reconstruction: A systematic review and meta-analysis

Mattey, Luke R., Reyes, Daniella, Rehma, Umar, Gohari, Shireen S., Sarwar, Mohammad Sohaib and Brennan, Peter A. 2025. FAMM flap in oral cavity and tongue defect reconstruction: A systematic review and meta-analysis. Journal of Plastic, Reconstructive and Aesthetic Surgery 102 , pp. 75-92. 10.1016/j.bjps.2024.12.009

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Abstract

Background: The Facial Artery Musculomucosal (FAMM) flap is a versatile flap based on the facial artery. It can be used for the reconstruction of the floor of the mouth, palate, tongue and alveolar ridge. The flap can be designed in various orientations and modified as an islanded or tunnelised flap. This study aims to review the use of the FAMM flap in the reconstruction of defects of the tongue and oral cavity, looking specifically at success rates and total complications. Methods: A literature search was conducted by two independent reviewers on PubMed, Dynamed, DARE, EMBASE, Cochrane and British Medical Journal (BMJ) electronic. (Registry CRD42024529989). Results: Twenty-seven studies fulfilled the search criteria and 407 FAMM flaps performed on 402 patients were extracted for analysis. 1.7% (n=7) of flaps failed with reasons being total necrosis (n=3), partial necrosis requiring surgical intervention and flap abandonment (n=2), total failure (n=1) and fistula formation (n=1). Overall, 26.0% (n=106) of patients experienced non-functional complications. Most commonly reported complications were partial necrosis (n=23, 5.7%), wound dehiscence (n=18, 4.4%) and venous congestion (n=13, 3.2%). The pooled success rate in all studies using FAMM flaps for oral cavity and tongue reconstruction was 99.47% (95% CI, 98.26 to 100.00, P = 1.00; I2 = 0%;). Pooled total complication rates were 30.18% (95% CI, 16.97 to 43.38, P < 0.01; I2 = 91%). Only thirty-five flaps required re-operation. Conclusions: Attracting low complication and failure rates, FAMM flaps are a safe and versatile option to consider in oral cavity and tongue reconstruction.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Biosciences
Publisher:	Elsevier
ISSN:	1748-6815
Date of First Compliant Deposit:	28 January 2025
Date of Acceptance:	18 December 2024
Last Modified:	04 Mar 2025 12:40
URI:	https://orca.cardiff.ac.uk/id/eprint/175674

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