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A buccinator flap operation aims to lengthen the soft palate. The surgeon moves some of the lining of the inside of the cheek on its blood supply to make the soft. [1] published the first anatomic description of a posterior buccinator myomucosal flap based on the buccal branch of the internal maxillary artery (Fig. 1), not to be. The buccinator myomucosal flap is effective in reducing/eliminating hypernasality in patients with cleft palate (± lip) and velopharyngeal insufficiency.

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The patient was discharged on postoperative day 1 on a soft solid diet.

Buccinator-based myomucosal flaps in intraoral reconstruction: A review and new classification

All patients were followed up for a minimum of 1 year after surgery. Facial artery is incorporated in the base of the flap.

The flap was secured with slow absorbing sutures and the donor site was closed primarily. Influence of palatal fistulas on velopharyngeal buccinato P indicates palate; b, buccinator musculomucosal flap; and t, tongue. Incidence of cleft palate fistula: Apropos of 22 cases. Buccal artery enters the posterior border of the muscle in junction with superior constrictor pharyngeal muscle; it accompanies buccal nerve. Intraoral cheek transposition flap for primary reconstruction of the anterior floor of the mouth.

Cheek flap for short palates. Technical and functional considerations. The buccal nerve, a branch of the mandibular nerve, travels with this artery Figure 7 and Figure 8.

Lippincott Williams and Wilkins; Cleft Palate Craniofac J ; Applications in dlap reconstruction.

Reconstruction flpa intraoral defects using facial artery musculomucosal flap. However, the proximity of the buccal nerve to the buccal artery and its buvcinator into the flap has been neglected. The fate of buccal mucosal flaps in primary palatal repair.


Skin grafts may not adhere to exposed bone and involve placement of a bolster that may be technically difficult in this area. The Bozola flap in oral cavity reconstruction. Nil Conflict of Interest: Applications in Intraoral Reconstruction.

Anatomic study and clinical application. Purchase access Subscribe now.

Table 3 Buccinator-based myomucosal pedicled flaps and their pivot points. Facial artery musculomucosal FAMM flap. Open in a separate window.

Buccinator flap as a method for palatal fistula and VPI management

A significant advantage is the inclusion of the buccal nerve with the vascular pedicle, allowing the flap to be sensate. Posterior buccal Pb that nourish posterior half of the buccinator muscle and anastomose the buccal artery. Unilateral flap was foap most commonly in primary repair of nasal side of wide unilateral cleft palate CP ; whereas, two flaps were used mostly in primary repair of wide bilateral CP and in secondary palate repair for buxcinator fistula.

Author information Article notes Copyright and License information Disclaimer. There was 1 partial flap necrosis the distal 3 mm in case 1 that was allowed to heal secondarily without sequelae. Cleft palate elongation and mucous grafting in the open wound nasal area in a single operative stage.

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The defect was allowed to heal secondarily. Surgical lengthening of the cleft palate by dissection of the neurovascular bundle. In addition, its donor site can be closed primarily with excellent cosmesis and function.


The only difference is in which side of the paddle superior, inferior, anterior, or posterior is the base, pedicled or islanded [ Figure 12 ].

Random pattern buccinator flaps have much less mucosal paddle. Support Center Support Center. This flap is very similar to the island cheek flap introduced by Sasaki in Table 2 New classification of buccinator-based myomucosal flaps suggested by literature.

Buccinator-based myomucosal flaps in intraoral reconstruction: A review and new classification

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. Six anatomical dissections were performed on 3 fresh cadaver heads to investigate the neurovascular supply to the flap.

Healing by secondary intention may risk contracture at the site with possible soft palate dysfunction.

Secondary palatal fistula and velopharyngeal insufficiency VPI are two major complications of palatoplasty. Small branches from the facial artery may require ligation as may anterior venous tributaries from the pterygoid plexus. Br J Oral Maxillofac Surg. The anteriorly based buccinator myomucosal island flap. Facial artery should be incorporated in flap base. This was evaluated by light touch with a tongue depressor over the mucosa of the transposed flap. The BMF was raised within 30 minutes without the use of magnification in all cases, minimizing total intraoperative time.

Donor site closed primarily [ Figure 7 ]. The patient was a year-old man with lower lip squamous cell carcinoma stage II.