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Posteriorly based Buccal Artery Myomucosal Flap: An Anatomical study
Majid Rezaei, Brian Figueroa, Richard Drake, Francis Papay, Bahar Bassiri Gharb, Antonio Rampazzo
Cleveland Clinic Foundation
2020-02-05
Presenter: Majid Rezaei
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature
Director Name: Bahar Bassiri Gharb
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial
Introduction:
The Buccinator flap is a versatile flap for the repair of cleft palate defects. Clinical applications of this flap have been well reported, however few anatomical studies have shed light on its vasculature. Therefore, the aim was to study the buccal neurovascular pedicle to design a new posteriorly based island flap.
Methods:
22 hemifacial dissections were performed on 11 fresh adult cadavers. External carotid or buccal artery was injected with red latex. Indocyanine green (ICG) angiography was performed in 6 hemifaces before the application of latex. Diameter of the buccal nerve and artery (extraorally), flap length, distance from pterygomandibular raphe to the pedicle entrance, and vertical distance of the pedicle entrance from maxillary tuberosity were measured intraorally. Then, the whole buccal mucosa and underlying soft tissue were harvested and examined with the surgical microscope.
Results:
The mean diameter of buccal artery and nerve was 0.95±0.29 mm and 1.29±0.20 mm, respectively. The mean vertical distance from the pedicle to the maxillary tuberosity was 11.57±3.87 mm. Flap length was on average 67.51±8.82 mm and the neurovascular pedicle entered the flap in the posterior 1:6 of the flap. ICG angiography showed that 84.8%± 13.9% of the flap length was instantly vascularized through the buccal arterial system.
Conclusion:
Our results demonstrated a consistent presence of the buccal artery in all dissected flaps. Its relatively large diameter and extensive branching toward the corner of the mouth, evidenced by ICG angiography, would allow the harvest of an island flap based only on the buccal artery.
