Buccinator Musculomucosal Flap
Applications in Intraoral Reconstruction
Greg R. Licameli, MD;
Robert Dolan, MD
Arch Otolaryngol Head Neck Surg. 1998;124:69-72.
Objective To evaluate the use of the buccinator musculomucosal flap in the reconstruction of defects of the oral cavity and oropharynx.
Design Prospective case series of 8 patients during a 1-year period with an average follow-up of 1 year. Six anatomical dissections were performed on 3 fresh cadaver heads to investigate the neurovascular supply to the flap.
Setting Academic tertiary referral medical center.
Results 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 previously received radiation therapy and who healed secondarily without sequelae. No patient experienced difficulties with mastication or oral competence. All patients reported light single-point touch sensation over the flap 2 weeks after surgery. Cadaveric dissections using latex or india ink injections demonstrated the posterior neurovascular supply 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 variety of intraoral reconstructions obviating the need for distal tissue harvest.
From the Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, Mass. Dr Licameli is now with the University of Illinois at Chicago.
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