Pedicled buccal fat pad flap for intraoral malignant defects: A series of 29 cases
15 January 2020 (online)
A buccal fat pad (BFP) as a flap for reconstruction of defects in the oral cavity has been described for a variety of benign conditions. We describe the indications, advantages, and complications of the BFP flap and report our clinical experience with the flap for intraoral reconstruction after tumor removal. From 2005 to 2008, we analyzed 29 patients in the age range of 32 to 82 years old who underwent a pedicled BFP flap reconstruction for oral defects after intraoral tumor removal. Postoperative wound healing and complications including any recurrence was followed-up prospectively. Most of the patients had an uneventful immediate postoperative period with signs of buccal fat pad epithelialization by the end of the first week and complete epithelialization at the end of the first month. On continued follow-up, a linear band of fibrous tissue under the epithelialized mucosa replaced the once reconstructed buccal fat pad. Three patients had varying degrees of hemorrhage: one of them had hematoma that healed with severe fibrosis and of the remaining two, one had a partial flap loss and one had a complete flap loss. Judicious use of buccal fat pad reconstruction offers a simple, convenient, and reliable way to reconstruct small to medium defects of the oral cavity with low morbidity, even in older patients who would not be able to tolerate time-consuming flap reconstruction procedures.
- 1 Egyedi P. Utilization of the buccal fat pad for closure of oroantral and/or oro-nasal communication. J Maxillofac Surg 1977;5:241-4.
- 2 Neder A. Use of buccal fat pad for grafts. Oral Surg Oral Med Oral Pathol 1983;55:349-50.
- 3 Tideman H, Bosanquet A, Scott J. Use of the buccal fat pad as a pedicled graft. J Oral Maxillofac Surg 1986;44:435-40.
- 4 Rapidis AD, Alexandridis CA, Eleftheriadis E, Angelopoulos. AP. The use of the buccal fat pad for reconstruction of oral defects: Review of the literature and report of 15 cases. Oral Maxillofac Surg 2000;58:158-63.
- 5 Hao SP. Reconstruction of oral defects with the pedicled buccal fat pad flap. Otolaryngo Head Neck Surg 2000;122:863-7.
- 6 Dean A, Alamillos F, Garcia-Lopez, A, Sanchez J, Penalba M. The buccal fat pad in oral reconstruction. Head Neck 2001;23:383-8.
- 7 Amin MA, Bailey BM, Swinson B, Witherow H. Use of the buccal fat pad in the reconstruction and prosthetic rehabilitation of oncological maxillary defects. Br J Oral Maxillofac Surg 2005;43:148-54.
- 8 Zhang HM, Yan YP, Qi KM, Wang JQ, Liu ZF. Anatomical structure of the buccal fat pad. and its clinical adaptations. Plast Reconstr Surg 2002;109:2509-18.
- 9 Ilankovan V, Soames JV. Morphometric analysis of orbital, buccal, and subcutaneous fats: Their potential in the treatment of enophthalmos. Br J Oral Maxillofac Surg 1995;33:40-2.
- 10 Loh FC, Loh HS. Use of the buccal fat pad for correction of intraoral defects: Report of cases. J Oral Maxillofac Surg 1991;49:413-6.
- 11 Racz L, Maros TN, Seres-Sturm L. Structural characteristics and functional significance of the buccal fat pad (corpus adiposum buccae). Morphol Embryol (Bucur) 1989;35:73-7.
- 12 Stuzin JM, Wagstrom L, Kawamoto HK, Baker TJ, Wolfe SA. The anatomy and clinical. applications of the buccal fat pad. Plast Reconstr Surg 1990;85:29-37.
- 13 Guven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg 1998;26:267-71.
- 14 El-Hakim IE, el-Fakharany AM. The use of the pedicled buccal fat pad (BFP) and palatal rotating flaps in closure of oroantral communication and palatal defects. J Laryngol Otol 1999;113:834-8.
- 15 Egyedi P, Müller H. Buccal fat pad flap plus skin graft to. oroantral and oronasal defects. In: Strauch B, Vasconez. LO, Hall-Findlay EJ, editors. Grabb's encyclopedia of flaps. Little, Brown and Co; p. 403-6.
- 16 Samman N, Cheung LK, Tideman H. The buccal fat pad in oral. reconstruction. Int J Oral Maxillofac Surg 1993;22:2-6.
- 17 Vuillemin T, Raveh J, Ramon Y. Reconstruction of the maxilla with bone grafts supported by the buccal fat pad. J Oral Maxillofac Surg 1988;46:100-6.
- 18 Martin-Granizo R, Naval L, Costas A, Goizueta C, Rodriguez. F, Monje F, et al. Use of buccal fat pad to repair intraoral defects: Review of 30 cases. Br J Oral Maxillofac Surg 1997;35:81-4.
- 19 Stajcic Z. The buccal fat pad in closure of oro-antral communication: A study of 56 cases. J Cranio Max Fac Surg 1992;20:193-7.
- 20 Hanazawa Y, Itoh K, Mabashi T, Sato K. Closure of oroantral communications using a pedicled buccal fat pad graft. J Oral Maxillofac Surg 1995;53:771-5.
- 21 Alkan A, Dolanmaz D, Uzun E, Erdem E. The reconstruction of oral defects with buccal fat pad. Swiss medical weekly: Official journal of the Swiss Society of Infectious Diseases. Swiss Med Wkly 2003;133:465-70.