title: Facial mimetic, cosmetic, and functional standardized assessment of the facial artery musculomucosal (FAMM) flap.
abstract: OBJECTIVE
  To objectively assess donor site morbidity after harvesting the facial artery musculomucosal flap. Use of the FAMM-flap in oral cavity reconstruction remains sporadic. This case series describes our newly developed standardized assessment of this flap in a floor of mouth (FOM) reconstructive setting.
  
  
  METHODS
  Standardized postoperative assessment of the FAMM flap for donor site wound complications, functional, facial mimetic and oncologic outcomes.
  
  
  RESULTS
  There were no wound complications. Oral competence remained intact, tongue mobility was good to excellent, average word articulation score was 98%, and mimetic function excellent in all patients. Three patients experienced ipsilateral upper lip anesthesia, and five patients were noted to have slight dysfunction of the orbicularis oris resulting in a loss of lip height at rest.
  
  
  CONCLUSIONS
  The FAMM flap is a reliable option for reconstruction of ablative defects of the FOM, and should be considered a workhorse flap for oral cavity defects. Unlike the submental island flap, a complete level I dissection may be concurrently performed without compromising the vascular supply to the FAMM flap.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Jowett
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA.
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
authors.affiliation: Department of Otolaryngology, Western Galilee Medical Center, Nahariya, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sela
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Miklos
authors.initials: M
authors.lastname: Toth
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Rainald
authors.initials: R
authors.lastname: Knecht
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: b.loerincz@uke.de.
authors.forename: Balazs B
authors.initials: BB
authors.lastname: Lörincz
mesh_terms: D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004954:Esthetics; D005152:Facial Muscles / Q000637:transplantation*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000601:surgery*; D009061:Mouth Mucosa / Q000601:surgery / Q000637:transplantation*; D009062:Mouth Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012904:Smiling; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Buccinator musculomucosal flap; Facial artery musculomucosal (FAMM) flap; Local flaps; Oral cancer; Reconstruction