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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Buccal fat pad covered the donor site [ Figure 9 ]. Clinical picture was very similar to that of wide adult palatal cleft. Our website uses cookies to enhance your experience. Besides, flaps were assessed regarding any complication such as clinical signs of ischemia and necrosis. Incidence and cluster occurrence of palatal fistula after furlow palatoplasty by a single surgeon.
All the donor sites were closed primarily leaving no raw surfaces, buccknator there were no adverse effects secondary to harvesting the muscle, particularly with respect to mastication, oral continence, or facial nerve dysfunction.
Random pattern buccinator myomucosal flap without including facial artery and vein is harvested, b Reconstructed defect, schematic picture.
Donor site closed primarily. Br J Plast Surg. Buccinator myomucosal flap in cleft palate repair: Donor site managed with buccal fat pad mobilization that clinically epithelialized 3 weeks later. BMF is one such type of intraoral flap that has been commonly used to reconstruct various intraoral defects such as oral cavity defects after oncologic resection. The patient was discharged home on postoperative day 1 on a soft solid diet. A mL syringe with an gauge angiocatheter was inserted into the internal maxillary artery and secured with a crimping silk suture, and the ink was injected under steady continuous pressure for approximately 15 seconds.
On follow-up visits, patients were examined to evaluate the success of palatal fistula closure and palatal lengthening. Amin Rahpeyma and Saeedeh Khajehahmadi 1. Lippincott Williams and Wilkins; Create a personal account to register for email alerts with links to free full-text articles.
These flaps can be used in reconstructive procedures other than oral cavity such as nasal cavity, orbit, and esophagus and buccintaor base reconstructions. Author information Copyright and License information Disclaimer.
Buccinator-based myomucosal flaps in intraoral reconstruction: A review and new classification
P indicates palate; d, donor site; and t, tongue. Anatomy Buccinator muscle originates posteriorly from pterygomandibular raphe and blend with orbicularis oris muscle anteriorly.
Br J Oral Maxillofac Surg. The formed flap was turned around the inferior border of the mandible and brought to the lingual side to cover the raw surface of lateral tongue. BMF has a reliable and consistent anatomy. The patient was discharged on postoperative day 1 on a soft solid diet.
Inferiorly based buccinator myomucosal pedicle flap was used for reconstruction. Isr Med Assoc J. Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad. Light touch perception was demonstrated over the flap at the 1-week clinic follow-up.
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 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Oral mucosa covers intraoral side and, in external surface, it is adjacent to the facial artery and vein, buccal fat pad, and buccopharyngeal fascia.
Extended Vomar flaps in cleft palate repair: Unilateral flap was used 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 large fistula.
Int J Pediatr Otorhinolaryngol. The buccal nerve is adjacent to the buccal artery and is easily included with the flap to maintain sensation to the overlying mucosa.
Buccinator musculomucosal flap b inset into defect and the donor site d closed primarily. Cleft palate elongation and mucous grafting in the open wound nasal area in a single operative stage. An buccinqtor experience with two-stage palatal repair. Donor site was closed with inferiorly based masseter muscle flap effectively [ Figure 4 ].
The flap was secured with slow absorbing sutures and the donor site was closed primarily.
Buccinator flap as a method for palatal fistula and VPI management
There was no need for pedicle base division. Regional flaps, such as the temporalis muscle flap, or free flaps such as the radial forearm, involve extensive extraoral dissection and are better reserved for larger defects.
The presented technique has been effective in anatomical and functional repair of wide palatal defects primary as well as secondary. Buccinator-based myomucosal flaps are not suitable for large oral mucosal defect coverage. Footnotes Source of Support: Patients who had a history of previous surgical correction of palatoplasty complications, and those who did not follow postoperative visitswere excluded from the study. We noted that the vascular anatomy seen in both our cadaveric and surgical patients agrees with descriptions presented in prior studies.
Facial artery musculomucosal FAMM flap.