Open Access
Table I
Advantages and disadvantages of available flaps for the reconstruction of defects of the oral mucosa. SGF, sublingual gland flap; FAMM, facial artery musculomucosal.
| Flap | Indications– Defect size – Localization |
Advantages | Disadvantages, complications |
|---|---|---|---|
| SGF | – Small and medium-sized defects <4 cm – Floor of mouth, tongue, gum, vestibule |
– Local flap – No donor site morbidity – Simple, quick |
– Not suitable for large defects – Salivary duct injury, mucocele, ankyloglossia (5.5%) |
| FAMM flap | – Small and medium-sized defects <8 × 3 cm – Floor of mouth ++, alveolar ridges, lips, palate, tongue |
– Local flap – Good esthetic outcomes – Dental rehabilitation (not a bulky or hairy flap) – No limitation of mouth opening |
– Not suitable for large defects – Bite blocker to protect pedicle – Second surgery at 2–3 weeks to cut the pedicle – Possible venous congestion, – partial flap necrosis, flap dehiscence |
| Buccinator flap | – Small and medium-sized defects <4 × 7 cm – Tongue, palate, retromolar triangle, floor of mouth |
– Local flap – Quick harvesting – Good functional and esthetic outcomes – Buccal nerve inclusion allowing the flap to be sensate |
– Not suitable for large defects – Bite blocker to protect pedicle – Second surgery at 2–3 weeks to cut pedicle – Partial flap necrosis (5.9%) and flap dehiscence (5%) |
| Buccal fat pad | – Small and medium-sized defects – Maxillary ++, retromolar triangle |
– Local flap – Short operating time |
– Not suitable for large defects – Possible cheek depression and limited mouth opening, partial flap necrosis (2.5%), and flap dehiscence (3.2%) |
| Nasolabial flap | – Small and medium-sized defects <4 × 5 cm – Floor of mouth, retromolar triangle, palate, tongue, alveolar ridges |
– Ease of surgery – Possible under Local anesthesia |
– Not suitable for large defects – Asymmetry of the nasolabial fold – Hairy flap – Cutaneous scar, dehiscence, and healing – Risk of orocutaneous fistula and iatrogenic dermoid cyst |
| Pedicled flap | – Large defects – Tongue, retromolar triangle, floor of mouth |
– Cover large defects | – Two operative sites – Recipient site morbidity (congestion, bulky flap) – Length of hospitalization |
| Free flap (forearm flap) | – Large defect – All localizations |
– Cover large defects – Reliable, versatile |
– Two operative sites – Frequent surgical revision – Length of hospitalization |
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