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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Inferiorly based buccinator myomucosal island flap that is harvested with intraoral incisions.

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The buccal artery, accompanying vein, and buccal nerve arise laterally at the posteroinferior aspect of the buccinator muscle. Route of single or two BMMF s transfer was bucicnator lateral or posterior to the greater palatine neurovascular bundle. Nerve damage, mouth opening difficulties and trismus are among the most important donor-site morbidities in surgical procedures performed on the oral cavity, especially in the cheek area.

The flaps were sutured buccinnator the recipient site using monocryl thread.

Donor site closed primarily [ Figure 7 ]. All patients had undergone primary palatoplasty before the first year of life. There were no tumor recurrences and no problems with mastication, oral continence, or facial nerve function. This study was designed to evaluate the use of the buccinator myomucosal flap in the reconstruction of palatal fistula and velopharyngeal insufficiency following primary palatoplasty.

A modification of the combined pushback and pharyngeal flap operation. Besides, flaps were assessed regarding any complication such as clinical signs of ischemia and necrosis.


Anteriorly based buccinator myomucosal flap was introduced by Carstens et al. Flap pedicle can be between facial artery and vein or in between facial artery and oral commissure [ Figure 10 ].

In the cases of VPI and patients who needed lengthening of the palate, double BMFs harvested from the both cheeks were used to repair defects. A loose areolar plane exists between the buccinator muscle and the buccopharyngeal fascia, facilitating the elevation of the flap with blunt dissection.

Similar to some other intraoral local flaps, BMF has buccinatr advantages including adequate amount of tissue, the ability to replace mucosa with mucosa, eliminating the need for external incision, reducing donor site morbidity, and optimal functional and cosmetic results. In axial pattern buccinator-based myomucosal flaps, the mucosal paddle is nearly constant.

Surg Gynecol Obstel ; Incidence of cleft palate fistula: In addition, external carotid artery resection or thrombosis may also jeopardize the viability of this flap.

Incidence and cluster occurrence of palatal fistula after furlow palatoplasty by a single surgeon. A total of 25 patients aged between 2 to 18 years who were bhccinator for surgical repair of secondary palatal fistula or VPI following palatoplasty were included in this study.

Buccal artery huccinator the posterior border of the muscle in junction with superior constrictor pharyngeal muscle; it accompanies buccal nerve. Cleft Palate Craniofac J ; The average time for the operation was 2.

Random pattern buccinator flaps have much less mucosal paddle. Buccinator muscle originates posteriorly from pterygomandibular raphe and blend with orbicularis oris muscle anteriorly.

Buccinator flap as a method for palatal fistula and VPI management

Floor of the mouth defects and lateral border of the tongue can be repaired with inferiorly based flaps. Therefore, a good amount of recent literature recommended use of intraoral local flaps harvested from the internal cheek area for repair of intraoral defects. Nil Conflict of Interest: Facial vein can be ligated to give the flap more mobility. The patient was a year-old man with melanoma of anterior maxilla. The fistula rate; in primary palatoplasty patients was 4.


Arch Otolaryngol Head Neck Surg. Buccal musculomucosal flap for reconstruction of wide vermilion and orbicularis oils muscle defect.

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

Wong FK, Hagg U. Note anastomosis between Pb and buccal artery. Please review our privacy policy.

On follow-up visits, patients were examined to evaluate the success of palatal fistula closure and palatal lengthening. Bozola believed that most blood supply of the buccinator muscle comes from the buccal artery. An analysis of six cases. Hong Kong Med J. Facial artery branches to buccinator muscle Ab are responsible for flap survival.

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

The formed flap was turned around the inferior border of the mandible and brought to the lingual side to cover the raw buccihator of lateral tongue. Case 4 The patient was a year-old edentulous male with mandibular ramus and angle ameloblastoma with perforation of soft tissue lingual to the ridge. A new intraoral flap: Anatomic study and clinical application.

Schematic blood supply of buccinator-based myomucosal flaps.