BUCCINATOR MUSCULOMUCOSAL FLAP - APPLICATIONS IN INTRAORAL RECONSTRUCTION

Objective: To evaluate the use of the buccinator musculomucosal flap i n the reconstruction of defects of the oral cavity and oropharynx. Des ign: Prospective case series of 8 patients during a 1-year period with an average follow-up of 1 year. Six anatomical dissections were perfo rmed on 3 fresh cadaver heads to investigate the neurovascular supply to the flap. Setting: Academic tertiary referral medical center. Resul ts: The buccinator musculomucosal flap was used in the reconstruction of 8 defects of the oral cavity, retromolar trigone, and soft palate. There was 1 partial flap necrosis that occurred in a patient who had p reviously received radiation therapy and who healed secondarily withou t sequelae. No patient experienced difficulties with mastication or or al competence. All patients reported light single-point touch sensatio n over the flap 2 weeks after surgery. Cadaveric dissections using lat ex or india ink injections demonstrated the posterior neurovascular su pply from the buccal artery, a branch of the internal maxillary artery , and the buccal nerve, a branch of the mandibular nerve. Conclusions: The buccinator musculomucosal flap is a dependable local sensate flap with a well-defined neurovascular pedicle that can be used in a varie ty of intraoral reconstructions obviating the need for distal tissue h arvest.