Oral oncology · 2026
Treatment pathways for oral tongue or floor of mouth reconstruction: A comparative analysis of islanded facial artery myomucosal flap and free anterolateral thigh flap.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lin Xiaozhen, Han Xiaodong, Wang Minghao, Shao Xiaojun, Du Zhaojie, Song Baixuan, Liu Huawei
Аннотация
PURPOSE: The free anterolateral thigh (ALT) flap is the mainstay for reconstructing intraoral defects after oral tongue (OT) or floor of mouth (FOM) squamous cell carcinoma (SCC) resection, but the islanded facial artery myomucosal (iFAMM) flap has emerged as an alternative for selected patients. This study compared perioperative outcomes, functional recovery, and hospitalization costs between the two reconstructive pathways in cT1-2 N0 OT/FOM SCC patients.
PATIENTS AND METHODS: This single-center retrospective cohort study included patients undergoing resection of cT1-2 N0 OT/FOM SCC with reconstruction using either the iFAMM or free ALT flap. Baseline characteristics, operative duration, complications, functional outcomes (mouth opening, swallowing, speech), esthetic outcomes, and hospitalization costs were compared, with effect sizes (95% CI) and multivariable regression adjusting for confounders.
RESULTS: Among 31 patients, 16 received iFAMM flap-based pathway treatment (iFAMM pathway) and 15 received free ALT flap-based pathway treatment (ALT pathway). While functional outcomes were comparable, the iFAMM pathway showed shorter operative time (514.4 ± 66.2 vs. 602.6 ± 95.2 min, p = 0.005), higher aesthetic VAS score (6.8 ± 1.5 vs. 4.9 ± 1.3, p = 0.001), and lower costs (8,848.7 ± 2,075.1 USD vs. 14,212.5 ± 2,719.9 USD, p < 0.0001). Multivariable regression confirmed flap-based pathway as an independent predictor for all the three primary outcomes.
CONCLUSION: The iFAMM pathway appears to be a promising alternative to the ALT pathway for surgical treatment of cT1-2 N0 OT/FOM SCC with comparable function, superior aesthetics, and lower costs. These exploratory findings warrant confirmation in prospective trials.
PATIENTS AND METHODS: This single-center retrospective cohort study included patients undergoing resection of cT1-2 N0 OT/FOM SCC with reconstruction using either the iFAMM or free ALT flap. Baseline characteristics, operative duration, complications, functional outcomes (mouth opening, swallowing, speech), esthetic outcomes, and hospitalization costs were compared, with effect sizes (95% CI) and multivariable regression adjusting for confounders.
RESULTS: Among 31 patients, 16 received iFAMM flap-based pathway treatment (iFAMM pathway) and 15 received free ALT flap-based pathway treatment (ALT pathway). While functional outcomes were comparable, the iFAMM pathway showed shorter operative time (514.4 ± 66.2 vs. 602.6 ± 95.2 min, p = 0.005), higher aesthetic VAS score (6.8 ± 1.5 vs. 4.9 ± 1.3, p = 0.001), and lower costs (8,848.7 ± 2,075.1 USD vs. 14,212.5 ± 2,719.9 USD, p < 0.0001). Multivariable regression confirmed flap-based pathway as an independent predictor for all the three primary outcomes.
CONCLUSION: The iFAMM pathway appears to be a promising alternative to the ALT pathway for surgical treatment of cT1-2 N0 OT/FOM SCC with comparable function, superior aesthetics, and lower costs. These exploratory findings warrant confirmation in prospective trials.