Reconstruction of intraoral defects is a challenging task which has known a progressive development from the use of prosthesis, to local, regional and free flaps. Although reconstruction with free flaps guarantees excellent rehabilitation both functionally and esthetically, however the use of microvascular techniques is demanding for the patients, and not always feasible. A variety of local flaps for reconstruction of intraoral defects have been described, and they represent an invaluable option to treat those patients that are not deemed good candidates for more complex reconstruction due to advanced age or poor general conditions.
Methods: we present a retrospective series of 27 consecutive patients who underwent intraoral reconstructions by locoregional flaps at the maxillofacial department of the Catholic University of Rome. Causes of the defects were: postoncological resection (15 cases), persistent oro-nasal fistula in cleft palate patients (7), post-infective oro-antral communication (3), oronasal communication in cocaine addicted (2). Defect sites were as follows: floor of the mouth, buccal mucosa, anterior palate, postero-lateral palate, retromolar trigone. The following locoregional flaps have been used singularly or in association: buccal fat pad, tongue flap, FAMM flap, nasolabial flap, superiorly-based melolabial flap, submental flap.
Results: None of the flaps utilized showed total failure; partial necrosis was recorded in two buccal fat flaps used for repairing of wide posterior palatal defects; three patients with oronasal communication developed recurrent fistula that required a second surgical repairing. All three cases were repaired using translational local flaps.
Conclusions: Locoregional flaps represent a valuable source for repairing a variety of oral cavity defects independently by location and dimension; they should be considered as precious tools in the armamentarium of any reconstructive surgeon in selected cases.
Key words: Loco-regional flaps; oral cavity defects; oral cavity reconstruction