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J Neurol Surg Rep 2016; 77(02): e98-e101
DOI: 10.1055/s-0036-1579630
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Modified Facial Artery Musculomucosal Flap for Reconstruction of Posterior Skull Base Defects

Liyue Xie
1   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, CHUM-Hôpital Notre-Dame, Montreal, Quebec, Canada
2   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
,
Philippe Lavigne
1   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, CHUM-Hôpital Notre-Dame, Montreal, Quebec, Canada
2   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
,
François Lavigne
1   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, CHUM-Hôpital Notre-Dame, Montreal, Quebec, Canada
,
Tareck Ayad
1   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, CHUM-Hôpital Notre-Dame, Montreal, Quebec, Canada
2   Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
› Author Affiliations
Further Information

Publication History

15 July 2015

30 December 2015

Publication Date:
20 June 2016 (online)

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Abstract

Objectives The superiorly pedicled facial artery musculomucosal (FAMM) flap has been successfully used for reconstruction of head and neck defects since 1992. Common sites of defects include the oral cavity and oropharynx. This article presents a clinical case in which we have successfully used a newly developed modification of the FAMM flap for bulky nasopharyngeal and skull base reconstruction.

Results Our patient is a 71-year-old man who presented with a large parapharyngeal and clival chordoma. After tumor removal through combined endoscopic and cervical approach, the internal carotid artery (ICA) in the nasopharyngeal portion was left exposed. A modified superiorly based FAMM flap measuring up to 10 cm in length and 2.5 cm in width was successfully harvested and used to completely cover the defect and the ICA. The flap survived local radiation therapy at the long-term follow-up.

Conclusion We have developed a new modification of the FAMM flap, using the fascia of the masseter muscle. This is the first reported case in the literature using a modified FAMM flap for the reconstruction of nasopharyngeal and skull base defect.

Keywords

skull base - reconstruction - facial artery musculomucosal flap - chordoma
 

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