목적: Conventional facial artery musculomucosal flaps(FAMM) provide effective surgical option for intraoral reconstruction but require two stage operations. Our teams newly developed FAMM island (FAMMi) flap and transpositional FAMM island(tFAMMi) flap without second stage operation. We report the noble use of FAMMi and tFAMMi flap for reconstruction of head and neck cancer 방법:FAMMi was raised as an 'island flap’and transferred to intraoral defect site. tFAMMi flap was transposed to the neck through a paramandibular tunnel and then moved to the intraoral defect through the floor of mouth. This was a retrospective study of 7 patients undergoing FAMMi flap and tFAMMi flap for oral cavity and oropharyngeal reconstruction. Between November 2012 and June 2015, 5 patients underwent tFAMMi flap after partial glossectomy and 2 patients underwent FAMMi flap for oropharyngeal defect in the retromolar trigone and tonsillar area.This study included surgical outcomes that were evaluated flap size, pedicle length, failure rate and complication. Preoperative and postoperative intraoral function was evaluated with the Functional Intraoral Glasgow Scale(FIGS). 결과:All flaps were successfully harvested and transferred during one stage operation, and donor sites were performed primary closure without dehiscence. Mean flap size was 5.7 x 2.6 cm and mean pedicle length was 8.5 cm. The only one case was required surgical revision for flap congestion. One patient presented gingivobuccal web on donor site. And 2 patients among tFAMMi flaps developed facial nerve palsy H-B Gr II. Patients resumed an oral diet after 1~3 days postoperatively. Mean preoperative FIGS score was 3.0 and mean 3-month postoperative FIGS score was better than the mean 1-month postoperative FIGS score(4.7 versus 7.2). 결론:Newly developed FAMMi and tFAMMi had advantages of the long pedicle and low flap failure and low donor site morbidity. These flaps can be a good option for the reconstruction of oral cavity and oropharyngeal defect.