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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An update on the aetiology of orofacial clefts. Buccinator myomucosal flap in cleft palate repair: The anterior limit of the flap is 1 cm behind the oral commissure. Larger donor sites always managed with buccal fat pad mobilization, which undergoes epithelialization.

Posterior superior alveolar PSA artery and vein enter it in the most posterior-superior corner and distribute over the buccinator muscle.

Footnotes Source of Support: Thin layer of buccinator muscle without including axial artery in it can survive if sufficient pedicle width is considered.

Buccinator flap as a method for palatal fistula and VPI management

Anatomical basis for its use in head and neck reconstructive surgery. Random pattern buccinator flaps relay on abundant vascular supply of buccinator muscle. Reconstruction of the floor of the mouth by means of an anteriorly based buccinator myomucosal island flap.

Nasal lining in partial cleft palate repair. At 1 year of follow-up the patient was free of disease. Isr Med Assoc J. Posteriorly based island pedicled buccinator flap foap a variant, in which the mucosa is incised circumferentially and mucosal paddle is separated from ubccinator adjacent mucosa, but the flap is attached to the underlying bufcinator that supply it via the buccal artery.

Under general anesthesia, wide surgical resection, and supraomohyoid neck dissection SOHND in the right side was done. Case 2 The patient was a year-old man with melanoma of anterior maxilla. Case 8 The patient was a 9-year-old boy with large peripheral giant cell granuloma in the mandibular alveolar ridge that extends from the right first permanent molar to the right canine area.


Tongue flaps usually require 2 stages, and speech and fkap may be adversely affected.

Their defects were repaired by buccinator myomucosal flaps BMFs. Using the von Langenbeck method predominantly, Muzaffar et al. The buccal mucosa and the buccinator muscle are incised to the level of the buccopharyngeal fascia, working in an anterior to posterior direction.

Regional flaps, such as the temporalis muscle flap, or free flaps such as the radial forearm, involve byccinator extraoral dissection and are better reserved buccjnator larger defects. A review of current clinical applications.

More than palatoplasties have undergone palate repair with the use of BMMFs between and Compared with surgical repair of defects bucclnator the oral cavity with free flaps which require competence in microsurgery and lengthy surgical buccinztor hospitalization periods, and may lead to donor-site morbidity with esthetically unsatisfactory results,[ 17 ] use of BMFs seems to be a more applicable, safe and effective method.

Lippincott Williams and Wilkins; Secondary palatal fistula and velopharyngeal insufficiency VPI are two major complications of palatoplasty.

There flao no tumor recurrences and no problems with mastication, oral continence, or facial nerve function. Facial artery branches to buccinator muscle Ab are responsible for flap survival.

The BMF has several advantages over other options that have been used in the reconstruction of oral cavity defects. All these vessels anastomosed with each other extensively [ Figure 1 ]. Inferior buccal branch, Pb: A year-old man who received prior radiation therapy for a T2 SCC of the tongue presented 9 months after a wide local excision of a T1, N0 SCC of the left retromolar trigone. Glandular branches and submental artery are ligated, d Inferiorly based buccinator myomucosal islanded flap that contains facial artery and vein turned under mandibular border and brought medial to the mandible, e Reconstructed defect, f buccal fat pad transposition, g Schematic picture.

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

Posterior buccal Pb that nourish posterior half of the buccinator muscle and anastomose the buccal artery. These flaps can be used in reconstructive procedures other than oral cavity such as nasal cavity, orbit, and esophagus and skull base reconstructions. There was only 1 partial flap failure case 1 in a patient with a prior resection in the same area as well as prior radiation therapy; however, it was inconsequential and was treated conservatively.


The defect buccinatr allowed to heal secondarily.

We noted that the vascular anatomy seen in both our cadaveric and surgical patients agrees with descriptions presented in prior studies.

The anatomy of the BMF is reliable and consistent. Reconstruction site 6 months after surgery.

Flap pedicle can be between facial artery and vein or in between facial artery and oral commissure [ Figure 10 ]. The patient was a year-old male patient with large oronasal fistula from surgical resection and radiotherapy of nasal cavity angiofibroma, 10 years ago.

The buccopharyngeal fascia should be ubccinator for 2 reasons: P indicates palate; b, buccinator musculomucosal flap; and t, tongue.

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

This artery communicates with infraorbital artery fla. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Therefore, re-operation was performed, and the buccinator flap was fixed to the site again. Sensory inputs are collected by buccal nerve, which is a branch of mandibular nerve, and enters the buccinator muscle via the posterior border.

Buccinator flap as a method for palatal fistula and VPI management

The pterygomandibular raphe and the oral commissure were considered as the posterior and anterior margins respectively. Bucvinator Oral Surg ;2: Some pioneer surgeons in buccinator-based myomucosal flaps and the terms that they introduced. The flap is islanded on a pedicle of the buccinator muscle. On direct laryngoscopy the lesion was found to be superficially invasive, measuring 2 cm in diameter.