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Jolly SS, Singh A, Rattan V. The Buccal Fat Pad as a Primary Flap for the Reconstruction of Intraoral Defect After Resection of Oral Cavity Malignant Tumors: A Retrospective Study. J Craniofac Surg 2023:00001665-990000000-01111. [PMID: 37800933 DOI: 10.1097/scs.0000000000009762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Among the various local and regional flaps used for the reconstruction of intraoral defects after oral cavity cancer surgery, the pedicled buccal fat pad (BFP) flap is considered a reliable alternative. Reconstruction with a BFP flap is particularly feasible in oral cavity areas, such as the posterior maxilla, buccal mucosa, retromolar trigone, and gingivobuccal sulcus. The purpose of this study was to analyze the outcomes of pedicled BFP as a primary reconstruction flap for small to medium intraoral posterior oral cavity postresection defects operated in our institute. METHODS This study was designed as a retrospective study. Thirty-seven patients with oral cavity cancer underwent wide local excision with adequate margins, followed by reconstruction of the defect with a pedicled BFP flap. Defect size, postoperative healing of the surgical site, mouth opening at 6 months, and any associated complications were assessed. RESULTS The mean age of the patients was 47.38±9.95 years with a male-to-female ratio of 3.6:1. Mean defect size at the greatest dimension was 5.01±1.39 cm. The mean preoperative mouth opening of patients was 35±6.4 mm, whereas the mean postoperative mouth opening after 6 months of follow-up was 27.8±9.2 cm. CONCLUSION The BFP flap is a convenient, reliable, and feasible reconstruction modality after oncological resection of posterior oral cavity cancers. Harvesting a BFP flap is minimally invasive with fewer complications, shorter recovery time, no donor site morbidity, and allows early initiation of adjuvant therapy postoperatively.
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Affiliation(s)
- Satnam Singh Jolly
- Department of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Nishikubo S, Matsuda H, Watanabe S, Tamura H, Tonogi M. Reconstruction of maxillary palatal defects after partial maxillectomy using a pedicled buccal fat pad and a nasolabial flap. Clin Case Rep 2021; 9:e04442. [PMID: 34295479 PMCID: PMC8287315 DOI: 10.1002/ccr3.4442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 11/25/2022] Open
Abstract
The novelty of this procedure is the reconstruction of a maxillary palatal defect with two pedicled flaps: a pedicled buccal fat pad and a nasolabial flap. This use of combination flaps makes the surgery simple, short, and useful for a wide defect.The novelty of this procedure is the reconstruction of a maxillary palatal defect with two pedicled flaps: a pedicled buccal fat pad and a nasolabial flap. This use of combination flaps makes the surgery simple, short, and useful for a wide defect.
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Affiliation(s)
- Shuichi Nishikubo
- First Department of Oral and Maxillofacial SurgeryNihon University School of DentistryTokyoJapan
| | | | - Shinya Watanabe
- Oral and Maxillofacial SurgeryKameda General HospitalChibaJapan
| | | | - Morio Tonogi
- First Department of Oral and Maxillofacial SurgeryNihon University School of DentistryTokyoJapan
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Consorti G, Catarzi L, Valassina D, Balercia P. Palatal reconstruction with tunnellized Bichat fat pad flap after tumour resection. Minerva Dent Oral Sci 2021; 71:168-173. [PMID: 33929131 DOI: 10.23736/s2724-6329.21.04459-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Reconstruction of palate defects following tumour ablative surgery can be a challenging problem. Different methods have been suggested over the time for the reconstruction of postoperative palatal defects. Since the first report of the Bichat fat pad flap in1977, it has become one of the most commonly used flaps for the reconstruction of palate after tumour excision. We report our results using the tunnellized Bichat fat pad (BFP) flap for 23 cases of palate reconstruction after minor salivary glands tumour excision. METHODS The Authors performed a tunnellized bichat fat pad flap for primary reconstruction of small- medium-sized surgical defects of the palate in 23 patients suffering from minor salivary glands palatal tumors in the period between 2016 and 2019. Each case was reviewed for primary pathologic findings, wound healing, postoperative complications. RESULTS All 23 tunnellized BFP procedures showed excellent recovery and uneventful follow-up. With this technique after 12 months follow-up complete wound healing after only 4 weeks without complication was observed. CONCLUSIONS The tunnellized BFP flap is useful, easy, and uncomplicated new alternative method for primary reconstruction of small to medium-sized palatal surgical defects, that can be performed with a very low morbidity. Submucosal tunnel for the pedicle passage introduced by the Authors adds some advantages in final outcomes with less discomfort for the patients, proving to be a technique able to adds itself to surgical reconstructive technique available today.
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Affiliation(s)
- Giuseppe Consorti
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy -
| | - Lisa Catarzi
- Maxillo-Facial Surgery Residency, Azienda Ospedaliera Universitaria Senese, Università degli Studi di Siena, Siena, Italy
| | - Davide Valassina
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy
| | - Paolo Balercia
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy
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Ayyash AM, Anstadt EE, Dvoracek LA, Marji FP, Lee JY, Losee JE, Goldstein JA. An Intraoperative Salvage After Transection of the Greater Palatine Artery During Cleft Palate Repair: A Case for Buccal Fat and Buccal Myomucosal Flaps. J Craniofac Surg 2020; 31:e133-e135. [PMID: 31934976 DOI: 10.1097/scs.0000000000006037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Recently, several adjunctive procedures have gained traction to aid cleft surgeons in repairing especially challenging palatal clefts. Buccal fat flaps and buccal myomucosal flaps have demonstrated particular utility in reinforcing thin palatal flaps or tissue deficits. Although their use has not been widely accepted, they may be particularly helpful in the setting of significant scarring or vascular compromise. Here the authors describe the case of an intraoperative salvage using bilateral buccal fat flaps and a right buccal myomucosal flap after transection of the right Greater Palatine artery (GPA) during palatoplasty on a 14-month old female with Pierre Robin Sequence and a wide Veau II cleft palate. For this operative salvage, bilateral buccal fat flaps were used to reinforce the hard-soft palate junction and a 4 cm × 2 cm flap of the right-sided buccal mucosa and buccinator muscle was inset along the majority of the right-sided soft and posterior hard palate. At 2 years follow-up, the patient had no significant complications and was doing well with healthy-appearing palatal tissue and age-appropriate speech.
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Affiliation(s)
| | - Erin E Anstadt
- Department of Plastic Surgery, University of Pittsburgh Medical Center, PA
| | - Lucas A Dvoracek
- Department of Plastic Surgery, University of Pittsburgh Medical Center, PA
| | - Fady P Marji
- Department of Plastic Surgery, University of Pittsburgh Medical Center, PA
| | | | - Joseph E Losee
- Department of Plastic Surgery, University of Pittsburgh Medical Center, PA
| | - Jesse A Goldstein
- Department of Plastic Surgery, University of Pittsburgh Medical Center, PA
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Mannelli G, Arcuri F, Comini L, Valente D, Spinelli G. Buccal Fat Pad: Report of 24 Cases and Literature Review of 1,635 Cases of Oral Defect Reconstruction. ORL J Otorhinolaryngol Relat Spec 2018; 81:24-35. [DOI: 10.1159/000494027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
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Kim MK, Han W, Kim SG. The use of the buccal fat pad flap for oral reconstruction. Maxillofac Plast Reconstr Surg 2017; 39:5. [PMID: 28286743 PMCID: PMC5325802 DOI: 10.1186/s40902-017-0105-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/01/2017] [Indexed: 11/10/2022] Open
Abstract
Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.
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Affiliation(s)
- Min-Keun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 Republic of Korea
| | - Wonil Han
- Han Dental Clinic, Guri, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 Republic of Korea
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Intra oral reconstruction with buccal fat pad: Recent applications of autologous tissue transplantation as a local flap. JPRAS Open 2016. [DOI: 10.1016/j.jpra.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bande C, Dawane P, Gupta MK, Gawande M, Rode V. Immediate versus delayed aggressive physical therapy following buccal fat pad interposition in oral submucous fibrosis-a prospective study in Central India. Oral Maxillofac Surg 2016; 20:397-403. [PMID: 27683297 DOI: 10.1007/s10006-016-0580-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Oral submucous fibrosis is a disease of an Indian subcontinent with obscure aetiology and poorly treated with varying signs and symptoms. OSMF occurs at any age but is most commonly seen in teenagers and adults in the age ranging between 16 and 35 years. A number of surgical treatments have been used for the treatment of oral submucous fibrosis with unpredictable results. PATIENTS AND METHOD In this study, 220 patients were randomly divided into two groups with mouth opening less than 16 mm and evaluated with immediate and delayed aggressive physiotherapy with buccal fat pad interposition after fibrotomy. Group A (n = 110) patients underwent aggressive mouth opening exercise from the next postoperative day while in group B (n = 110), patients underwent physiotherapy 7th day postoperatively. Pain and discomfort, mucosalization, infection, flap dehiscence and necrosis were noted. Patients were followed for 1 year on a regular interval basis. RESULTS At the end of 1-year follow up, the post-operative mean mouth opening in group A was 38.63 mm and 34.19 mm in group B. In group A, the immediate physiotherapy results in mild to moderate pain and discomfort to the patients as compared to no apparent pain in the group B. The mean mucosalization time in group A and group B was 4.2 and 5.1 weeks, respectively. Postoperatively, all patients achieve satisfactory mouth opening. CONCLUSION Immediate aggressive physiotherapy yields a comparatively superior result than delayed physiotherapy with respect to mouth opening in 1 year of follow-up.
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Affiliation(s)
| | - Pawan Dawane
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - M K Gupta
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - Mayur Gawande
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - Vijay Rode
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
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Dermal Matrix for Intraoral Lining Following Composite Mandibular Defect Reconstruction With Chimeric Fibular Osseocutaneous Flap. J Craniofac Surg 2016; 27:1711-1714. [PMID: 27763972 DOI: 10.1097/scs.0000000000002930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering. The patient was managed with a chimeric osseocutaneous free fibula flap to restore the mandibular bone and chin skin defect, followed by a second-stage reconstruction of the intraoral defect with bilayer Integra. Complete release of tongue tethering was achieved enabling normal speech and deglutition and allowing for dental rehabilitation. CONCLUSIONS Integra was safely used as an alternative for intraoral lining, in composite mandibular reconstruction, downgrading reconstructive demands and offering optimal functional results.
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Habib AMA, Medra A. The Feasibility of Buccal Fat Pad Flap in Oral Reconstruction Based on Clinical Experience in a Governmental Hospital, Alexandria, Egypt. Cleft Palate Craniofac J 2015; 53:657-663. [PMID: 26606163 DOI: 10.1597/15-106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the pedicled buccal fat pad flap for its applicability in the reconstruction of surgically created oral defects. We highlighted the technique of flap harvesting, its different applications, and limitations. DESIGN Prospective analysis of patients with intraoral defects repaired by the buccal fat pad flap. SETTING Institutional center. PATIENTS/PARTICIPANTS Twenty-nine patients with surgical defects of the palate, maxilla, upper gingiva, buccal mucosa, lower gingiva, retromolar region, oral floor, and temporomandibular joint. INTERVENTIONS Pedicled buccal fat pad flap for treatment of small to medium-sized intraoral defects. OUTCOME MEASURES Patients had repair using a pedicled buccal fat pad flap between 2012 and 2014. Patients' photographs and clinical records were collected. The technique of flap harvesting, its advantages, and its drawbacks are described in this study. RESULTS Patients were followed up over a mean period of 13.7 months to check flap viability, competent repair, and donor site function and aesthetics. Complete epithelialization was observed within 4 to 6 weeks postoperatively according to the extent of the defect. All patients showed uneventful healing without complications. CONCLUSIONS Buccal fat pad flap proved to be feasible for the reconstruction of surgically induced proximal small to medium-sized defects and can be extended to the palate, mandible, mouth angle, and temporomandibular joint region. Further research using preoperative computed tomography or magnetic resonance imaging for evaluation of the size of the buccal fat pad is needed when reconstructing large distal defects.
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Berrone M, Florindi FU, Carbone V, Aldiano C, Pentenero M. Stage 3 Medication-Related Osteonecrosis of the Posterior Maxilla: Surgical Treatment Using a Pedicled Buccal Fat Pad Flap: Case Reports. J Oral Maxillofac Surg 2015; 73:2082-6. [PMID: 26183009 DOI: 10.1016/j.joms.2015.06.165] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 06/20/2015] [Accepted: 06/22/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE Stage 3 medication-related osteonecrosis of the jaw (MRONJ) sometimes requires surgical treatment for resolution of the pathology and, in many cases, leads to oroantral communication in the posterior maxilla. The buccal fat pad flap is considered the best surgical choice for closure of large oroantral communications because it provides primary closure and guarantees adequate bone protection with sufficient blood supply for an effective bone healing process. MATERIALS AND METHODS Five consecutive patients affected by stage 3 posterior maxillary MRONJ were treated with surgical removal of the necrotic bone and primary closure of the oroantral communication using a buccal fat pad flap. RESULTS In each case, the size of the flap was always sufficient to perfectly close the defect without tension. There were no postoperative complications and the average postoperative hospital stay was 3 ± 1 days. The patients were seen at monthly follow-ups; after 12 ± 4 months of follow-up, no problems were noted in the treated area. CONCLUSION Despite the limited number of cases, the results of this study suggest that, for stage 3 posterior maxilla MRONJ, managing the site with a pedicled buccal fat pad flap and primary closure might guarantee adequate bone protection with sufficient blood supply for an effective bone healing process.
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Affiliation(s)
- Mattia Berrone
- Resident, PhD Program in Experimental Medicine and Therapy, Department of Oncology, University of Turin, Turin, Italy.
| | - Filippo Umberto Florindi
- Resident, Oral Surgery Specialty School, Department of Oncology, University of Turin, Turin, Italy
| | - Vincenzo Carbone
- Member of the medical staff Oral Surgery Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Carola Aldiano
- Resident, Oral Surgery Specialty School, Department of Oncology, University of Turin, Turin, Italy
| | - Monica Pentenero
- Associate Professor, Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, Turin, Italy
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Ye W, Song Y, Ying B, Hu J, Zhang C, Zhang Z. Use of the buccal fat pad in the immediate reconstruction of palatal defects related to cancer surgery with postoperative radiation therapy. J Oral Maxillofac Surg 2014; 72:2613-20. [PMID: 25262397 DOI: 10.1016/j.joms.2014.06.459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 06/30/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the use of the buccal fat pad (BFP) in the immediate reconstruction of oncologic palate defects and the influence of postoperative radiotherapy on reconstruction. PATIENTS AND METHODS Patients who were diagnosed with moderate- to high-grade malignancies of the palate underwent partial maxillectomy. The BFP was used as a pedicled flap to reconstruct the defects. All patients received postoperative radiotherapy 4 to 5 weeks after surgery. RESULTS Eighteen patients (9 men and 9 women; age range, 37 to 81 yr) underwent surgery and subsequent radiotherapy. The size of all defects ranged from 7.5 to 19.2 cm2. Adequate closure of the defects was achieved during surgery and all flaps were epithelialized within 3 weeks after surgery, with no complications of dehiscence or flap failure. Furthermore, there were no complications derived from postoperative radiotherapy. CONCLUSIONS This study suggests that BFP grafting is an effective and reliable method for the reconstruction of small to medium-size palate defects. Furthermore, postoperative radiotherapy does not influence the success of reconstruction.
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Affiliation(s)
- Weimin Ye
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yipeng Song
- Associate Professor, Department of Radiotherapy, Yu-Huang-Ding Hospital affiliated to Tsingtao University, Yantai, China
| | - Binbin Ying
- Associate Professor, Department of Stomatology, Ningbo First Hospital, Ningbo, China
| | - Jingzhou Hu
- Attending Surgeon, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Chenping Zhang
- Professor, Department Head, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhiyuan Zhang
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
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Tavakolinejad S, Ebrahimzadeh Bidskan A, Ashraf H, Hamidi Alamdari D. A glance at methods for cleft palate repair. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15393. [PMID: 25593724 PMCID: PMC4270645 DOI: 10.5812/ircmj.15393] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 01/13/2014] [Accepted: 01/21/2014] [Indexed: 01/17/2023]
Abstract
Context: Cleft palate is the second most common birth defect and is considered as a challenge for pediatric plastic surgeons. There is still a general lack of a standard protocol and patients often require multiple surgical interventions during their lifetime along with disappointing results. Evidence Acquisition: PubMed search was undertaken using search terms including 'cleft palate repair', 'palatal cleft closure', 'cleft palate + stem cells', 'cleft palate + plasma rich platelet', 'cleft palate + scaffold', 'palatal tissue engineering', and 'bone tissue engineering'. The found articles were included if they defined a therapeutic strategy and/or assessed a new technique. Results: We reported a summary of the key-points concerning cleft palate development, the genes involving this defect, current therapeutic strategies, recently novel aspects, and future advances in treatments for easy and fast understanding of the concepts, rather than a systematic review. In addition, the results were integrated with our recent experience. Conclusions: Tissue engineering may open a new window in cleft palate reconstruction. Stem cells and growth factors play key roles in this field.
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Affiliation(s)
- Sima Tavakolinejad
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Alireza Ebrahimzadeh Bidskan
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hami Ashraf
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Daryoush Hamidi Alamdari
- Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding Author: Daryoush Hamidi Alamdari, Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9151017650, E-mail:
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Manuel S, Kumar S, Nair PR. The Versatility in the Use of Buccal Fat Pad in the Closure of Oro-antral Fistulas. J Maxillofac Oral Surg 2014; 14:374-7. [PMID: 26028861 DOI: 10.1007/s12663-014-0669-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 07/07/2014] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Oroantral communications (OAC) are probable surgical complications of dentoalveolar procedures. OACs 2 mm in diameter or smaller are likely to close spontaneously without the need for any surgical intervention. However, OACs 3 mm in diameter or larger, or OACs associated with maxillary or periodontal inflammation, may persist, and surgical closure is recommended. Various surgical techniques have been suggested for the closure of oroantral defects. CASE DETAILS We have found the technique of two layer closure with buccal fat pad (BFP) and buccal mucoperiosteum quite useful for closure of chronic Oroantral fistula (OAF) and this article reports a case of OAF in the left first molar region of a 50 year old male, which has been closed successfully with this technique. CONCLUSION Buccal fat pad is a pedicled locally available flap which has its own blood supply and hence can be used with great efficacy in closure of OAF. This paper aims to elaborate the surgical details of this technique and its usefulness in closure of chronic OAF.
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Affiliation(s)
- Suvy Manuel
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Sciences, Thiruvananthapuram, India
| | - Surej Kumar
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Sciences, Thiruvananthapuram, India
| | - Parvathi R Nair
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Sciences, Thiruvananthapuram, India
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Weinstock RJ, Nikoyan L, Dym H. Composite Three-Layer Closure of Oral Antral Communication With 10 Months Follow-Up—A Case Study. J Oral Maxillofac Surg 2014; 72:266.e1-7. [DOI: 10.1016/j.joms.2013.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/12/2013] [Accepted: 09/17/2013] [Indexed: 11/30/2022]
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Candamourty R, Jain MK, Sankar K, Babu MRR. Double-layered closure of oroantral fistula using buccal fat pad and buccal advancement flap. J Nat Sci Biol Med 2012; 3:203-5. [PMID: 23225989 PMCID: PMC3510921 DOI: 10.4103/0976-9668.101930] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Some of the traditional methods that are being employed in the repair of oroantral communication can be broadly divided into local and distant flaps. Recently, because of various advantages, buccal fat pad is increasingly being employed in the repair of oroantral fistula and other oral defects worldwide. However, there are some problems that can be encountered while harvesting BFP which has to be taken care of. In this paper, we present a case with one of such problems, its management, and review of literature on the same.
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Affiliation(s)
- Ramesh Candamourty
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Mahatma Gandhi Medical College and Research Institute Campus, Pillaiyarkuppam, Pondicherry, India
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Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J 2012; 6:94-8. [PMID: 22715347 PMCID: PMC3377926 DOI: 10.2174/1874210601206010094] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 04/18/2012] [Accepted: 04/19/2012] [Indexed: 11/22/2022] Open
Abstract
Oral fistula (OAF) is a pathological communication between the oral cavity and maxillary sinus which has its origin either from iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma. OAF closures can be achieved using different flaps which show both advantages and limitations. Therefore they all need careful consideration in order to select the best approach depending on the situation. The most widely employed flaps are of three types: vestibular flap, palatal flap and buccal fat pad Flap(BFP). The authors present three cases of OAF with the different techniques. It is suggested that the buccal flap is best applied in the case of large fistulas located in the anterior region, the palatal flap is suitable to correct premolar defects and the BFP flap for wide posterior OAFs.
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Application of the buccal fat pad in oral and maxillofacial reconstruction: Review of 35 cases. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2012. [DOI: 10.1016/j.ajoms.2011.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Youn T, Lee CS, Kim HS, Lim K, Lee SJ, Kim BC, Nam W. Use of the pedicled buccal fat pad in the reconstruction of intraoral defects: a report of five cases. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.2.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Taegyun Youn
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Choong-Sang Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyoungmin Lim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seung-June Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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Levi B, Brugman S, Wong VW, Grova M, Longaker MT, Wan DC. Palatogenesis: engineering, pathways and pathologies. Organogenesis 2011; 7:242-54. [PMID: 21964245 DOI: 10.4161/org.7.4.17926] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cleft palate represents the second most common birth defect and carries substantial physiologic and social challenges for affected patients, as they often require multiple surgical interventions during their lifetime. A number of genes have been identified to be associated with the cleft palate phenotype, but etiology in the majority of cases remains elusive. In order to better understand cleft palate and both surgical and potential tissue engineering approaches for repair, we have performed an in-depth literature review into cleft palate development in humans and mice, as well as into molecular pathways underlying these pathologic developments. We summarize the multitude of pathways underlying cleft palate development, with the transforming growth factor beta superfamily being the most commonly studied. Furthermore, while the majority of cleft palate studies are performed using a mouse model, studies focusing on tissue engineering have also focused heavily on mouse models. A paucity of human randomized controlled studies exists for cleft palate repair, and so far, tissue engineering approaches are limited. In this review, we discuss the development of the palate, explain the basic science behind normal and pathologic palate development in humans as well as mouse models and elaborate on how these studies may lead to future advances in palatal tissue engineering and cleft palate treatments.
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Affiliation(s)
- Benjamin Levi
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Plastic and Reconstructive Surgery Division, Stanford University School of Medicine, Stanford, California, USA
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Poeschl PW, Baumann A, Russmueller G, Poeschl E, Klug C, Ewers R. Closure of oroantral communications with Bichat's buccal fat pad. J Oral Maxillofac Surg 2009; 67:1460-6. [PMID: 19531418 DOI: 10.1016/j.joms.2009.03.049] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Revised: 01/15/2009] [Accepted: 03/07/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the use of the pedicled buccal fat pad for the closure of oroantral communications (OACs) and to describe our experience with this surgical procedure. PATIENTS AND METHODS A retrospective review of 161 patients treated at the University Hospital for Cranio-Maxillofacial and Oral Surgery in Vienna, Austria, from 2000 to 2005, with the diagnosis of an OAC was performed. All defects were closed by application of a buccal fat pad. Data were obtained from chart review, a compiled database, and clinical follow-up and included the location of the defect, the cause of the OAC, the modality of anesthesia, intraoperative complications, any complications during the process of wound healing, and any late adverse effects. RESULTS The buccal fat pad for closure of an OAC was successfully used in 161 patients at our department. In 12 patients (7.5%), the closure of the OAC was insufficient, and a second operation was necessary. Excluding all severe and complicating cases such as tumor-related defects or previously treated cases, the overall success rate for closure of the OAC was nearly 98%. No late complications occurred, and all patients were free of pain or any limitations after the 6-month follow-up period. CONCLUSIONS According to the recommendations and anatomic limitations reported in published studies and discussed in the present report, the application of the buccal fat pad is a safe and reliable procedure for closing an OAC.
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Affiliation(s)
- Paul W Poeschl
- University Hospital for Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
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Yeshaswini T, Thomas Joseph P. Pedicled BFP for closure of oro-antral fistula revisited. J Maxillofac Oral Surg 2009; 8:134-6. [PMID: 23139491 DOI: 10.1007/s12663-009-0033-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 06/02/2009] [Indexed: 11/30/2022] Open
Abstract
The Buccal Fat Pad (BFP) has been increasingly employed in the reconstruction of intra-oral defects since the procedure was first described by Egyedi. Although the use of BFP for closure of oro-antral communications has been reported in literature, it is either not a common practice or is under reported in India. This article describes predictive results with 2 cases of chronic oro-antral fistula using pedicled BFP.
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Affiliation(s)
- T Yeshaswini
- Dept. of Oral and Maxillofacial Surgery, Coorg Institute of Dental Sciences, Coorg, Karnataka India ; Dept. of Oral and Maxillofacial Surgery, Coorg Institute of Dental Sciences, K K Campus, Maggula PO Virajpet, 571218 Coorg, Karnataka India
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Hassani A, Khojasteh A, Alikhasi M. Repair of the perforated sinus membrane with buccal fat pad during sinus augmentation. J ORAL IMPLANTOL 2009; 34:330-3. [PMID: 19133488 DOI: 10.1563/1548-1336-34.6.330] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several reports demonstrate successful use of the buccal fat pad (BFP) as pedicled graft in reconstructing small to medium sized maxillary defects. BFP harvesting has so far been shown to be an easy, well-tolerated, and uncomplicated technique for oral reconstruction. This case report proposes the use of BFP for repairing of the perforated sinus membrane during sinus augmentation.
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Affiliation(s)
- Ali Hassani
- Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran
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Hassani A, Khojasteh A, Alikhasi M, Vaziri H. Measurement of volume changes of sinus floor augmentation covered with buccal fat pad: a case series study. ACTA ACUST UNITED AC 2008; 107:369-74. [PMID: 18996030 DOI: 10.1016/j.tripleo.2008.08.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 08/20/2008] [Accepted: 08/31/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the volumetric changes of the maxillary sinus graft in conjunction with buccal fat pad (BFP) covering the lateral sinus wall. STUDY DESIGN In this article, the radiographic results are presented on 11 consecutively treated patients using an equal mixture of the autogenous bone harvested from the tuberosity and natural bone mineral (Bio-Oss) used to augment the maxillary sinus. Buccal fat pad was used over the lateral sinus wall in all cases as a membrane to cover the augmentation material. The mean initial bone height (IBH) was 3.82 mm as measured in the posterior maxilla. Three months after sinus elevation, radiographic evaluation was performed for the patients and secondary bone height was measured (SBH(1)). Fifty-two implants were placed in augmented sinuses. Prosthetic rehabilitation of the patients was done 4 months after inserting the implants. Radiographs were taken 6 months after implant placement and secondary bone height was measured (SBH(2)). RESULTS Of 52 implants, 51 (98%) were considered clinically successful. One implant was removed because of mobility at the time of surgical exposure. Clinically, no complications were observed, and all implants were considered clinically osseointegrated after 6 months. Mean bone height was measured as 3.82 mm before sinus grafting. SBH(1) and SBH(2) were measured as 12.22 mm and 10.5 mm respectively. CONCLUSION The clinical findings suggested that BFP might be a substitute for bioresorbable collagen membranes in maxillary and sinus floor bone grafts.
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Affiliation(s)
- Ali Hassani
- Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran
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Affiliation(s)
- Kevin Arce
- Department of Oral and Maxillofacial Surgery, John Peter Smith Hospital, 1500 S. Main Street, Fort Worth, TX 76104, USA.
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Amin MA, Bailey BMW, 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. [PMID: 15749216 DOI: 10.1016/j.bjoms.2004.10.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2004] [Indexed: 11/18/2022]
Abstract
We evaluated the effectiveness of the buccal fat pad as a pedicled flap for intraoral reconstruction after partial maxillectomy for neoplastic disease in 24 patients, and subsequently, in providing support for a denture. In all patients the buccal fat pad was covered with a split-skin graft and an acrylic plate. There was complete healing of the buccal fat pad flap within 6 weeks in 18 patients with no major complications, and minimal effects on speech and eating. In six cases there was partial dehiscence of the flap, which healed spontaneously in one patient and was repaired with local flaps in two others. There were no cases of complete breakdown of the flap. Eight patients so far have been rehabilitated with small dentures. In conclusion, the buccal fat pad flap is a simple, quick, and reliable method of reconstruction of small to medium-sized posterior maxillary alveolar defects.
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Affiliation(s)
- M A Amin
- S.W. London Regional Maxillofacial Service, St. George's Hospital Medical School, Blackshaw Road, Tooting, London SW170QT, UK.
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Raguse JD, Gath HJ. The buccal fad pad lined with a metabolic active dermal replacement (Dermagraft) for treatment of defects of the buccal plane. ACTA ACUST UNITED AC 2004; 57:764-8. [PMID: 15544774 DOI: 10.1016/j.bjps.2004.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 05/13/2004] [Indexed: 10/26/2022]
Abstract
The buccal fad pad flap (BFPF) is an easy to raise pedicled flap for closure of intraoral defects with barely any donor defect. The major disadvantage of the BFPF is the missing epithelial lining, which can induce fibrous tissue formation with resulting functional impairment. To overcome this problem we lined the BFPF with a dermal replacement (Dermagraft) consisting of living metabolic active fibroblasts. In six patients, defects resulting from tumour removal were reconstructed with a combination of the BFPF and Dermagraft and followed up for at least 2 years. In all patients a defect closure was achieved with no functional impairment. The clinical character which was achieved was more a type of defect regeneration than a flap closure. The availability of bioengineered metabolic active tissue can overcome the major problem of the BFPF as an option for defect closure of the buccal side. Furthermore the regeneration of the defects optimises clinical tumour monitoring.
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Affiliation(s)
- J D Raguse
- Clinic for Oral and Maxillofacial Surgery, Charité University Clinic, Augustenburgerplatz 1, 13353 Berlin, Germany.
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31
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Colella G, Tartaro G, Giudice A. The buccal fat pad in oral reconstruction. ACTA ACUST UNITED AC 2004; 57:326-9. [PMID: 15145735 DOI: 10.1016/j.bjps.2004.02.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2003] [Accepted: 02/17/2004] [Indexed: 11/19/2022]
Abstract
UNLABELLED We describe the indications, advantages, and complications of the buccal fat pad (BFP) flap and report our clinical experience with the flap for intraoral reconstruction after tumour removal. METHODS From 1993 to 2002, a pedicled BFP flap was used to reconstruct oral defects after tumour removal in 15 patients, prospectively analysed. RESULTS Adequate closure of the defect was achieved. In seven cases there was some retraction of the BFP. CONCLUSIONS The BFP, as a flap, offers a good and simple option in the reconstruction of small to medium defects in the oral cavity, above all in older patients. The greatest disadvantage is that reduction in oral opening could occur, to an unpredictable degree.
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Affiliation(s)
- Giuseppe Colella
- Department of Head and Neck Pathology, Seconda Universita degli Studi di Napoli, Facolta di Medicina e Chirurgica, Napoli, Italy
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Zhong LP, Chen GF, Fan LJ, Zhao SF. Immediate reconstruction of maxilla with bone grafts supported by pedicled buccal fat pad graft. ACTA ACUST UNITED AC 2004; 97:147-54. [PMID: 14970773 DOI: 10.1016/j.tripleo.2003.09.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To reconstruct immediately the maxilla with bone grafts after partial maxillary resection and solve complications of exposed bone grafts to the maxillary sinus leading to a high rate of bone infection and sequestration. STUDY DESIGN Thirty-eight patients were treated by immediate reconstruction of the maxilla with bone grafts supported by pedicled buccal fat pad (BFP) graft. The facial contour, the bone healing of the bone grafts, and the function of the maxillary sinus were evaluated with the Waters radiograph and speech evaluation. RESULTS The postoperative healing was satisfactory with normal mouth opening and symmetrical contour of the face. The function of the maxillary sinus was restored with satisfactory speech and symmetrical density on radiograph and the healing of the bone grafts was good without complications such as bone resorption and sequestration. CONCLUSIONS Immediate reconstruction of the maxilla with bone grafts supported by pedicled BFP grafts can restore the facial contour and the function of the maxillary sinus for the patients with partial maxillary resection. It provides a good method to reconstruct the maxillary defects and function in the mouth.
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Affiliation(s)
- Lai-Ping Zhong
- Zhejiang Univeristy College of Medicine, Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Hangzhou, China.
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Dean A, Alamillos F, García-López A, Sánchez J, Peñalba M. The buccal fat pad flap in oral reconstruction. Head Neck 2001; 23:383-8. [PMID: 11295812 DOI: 10.1002/hed.1048] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study is to describe the surgical technique, indications, advantages, and possible complications of the buccal fat pad flap and to report our clinical experience with this flap for intraoral reconstruction after tumor removal. METHODS The flap has been used to reconstruct oral defects after tumor resection in 32 patients, who have been retrospectively analyzed. RESULTS Adequate closure of the defect was achieved during surgery in all cases. In one case, there was partial loss of the flap; this was treated conservatively. In five cases there was some retraction in the reconstructed area. CONCLUSIONS Buccal fat pad as a flap offers an adequate reconstructive option to be born in mind when reconstructing small to medium defects in the oral cavity. It is a simple and quick surgical technique with a low incidence of complications.
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Affiliation(s)
- A Dean
- Department of Oral and Maxillofacial Surgery, Reina Sofía University Hospital, C/ José Ma Martorell 4, 2 -2, 14005 Córdoba, Spain.
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Pandolfi P, Yavuzer R, Jackson I. Three-layer closure of an oroantral-cutaneous defect. Int J Oral Maxillofac Surg 2000. [DOI: 10.1016/s0901-5027(00)80118-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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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. J Oral Maxillofac Surg 2000; 58:158-63. [PMID: 10670594 DOI: 10.1016/s0278-2391(00)90330-6] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although the buccal fat pad (BFP) was originally used as an alternative method for the closure of small to medium-sized oroantral and oronasal communications, its use has now been extended to use after excision of oral malignancies. This report describes experience with this technique. PATIENTS AND METHODS The BFP was used as a pedicled graft to reconstruct medium-sized surgical defects of the oral soft and hard tissues in 15 patients suffering from oral malignant tumors. Six of the defects were in the maxilla, 3 in the retromandibular area, and 6 in the cheek and oral commissure. The BFP was left uncovered to epithelialize in 14 patients, and in one it was covered with lyophilized dura. RESULTS The BFP healed without complications within 3 to 4 weeks in 13 patients, whereas in 2 patients with maxillary defects there was partial loss of the graft, requiring the additional use of an obturator in 1 case and a tongue flap in another to prevent oronasal leakage. Harvesting the graft proved to be extremely easy, and care was only necessary to avoid severing the supporting vascular plexus and the thin capsule covering the BFP. CONCLUSIONS The findings support the view that the BFP is a useful, easy, and uncomplicated alternative method for the reconstruction of small to medium-sized surgical defects of the oral hard and soft tissues.
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Affiliation(s)
- A D Rapidis
- Department of Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens University School of Dentistry.
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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. [PMID: 10664688 DOI: 10.1017/s0022215100145335] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The use of the buccal fat (BFP) and palatal rotating flaps for the closure of oro-antral communication and reconstruction of palatal defects was compared clinically. The BFP proved to be consistently successful in closing oro-antral fistulae and palatal defects resulting from tumour resection, preserving the normal anatomical architecture of the oral mucosa. No denuded area requiring secondary granulation was required as in the case of palatal flaps. In addition, no facial disfigurement was observed on the operated side. BFP is considered a reliable, convenient method for closure of palatal defects and closure of oro-antral communication. It can also be considered as a reliable back-up procedure in the event of failure of other techniques.
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Affiliation(s)
- I E el-Hakim
- Department of Dental Medicine, Bab El-Sheria University Hospital of Al-Azhar University, Cairo, Egypt.
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38
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Laskin DM. Management of Oroantral Fistula and other Sinus-Related Complications. Oral Maxillofac Surg Clin North Am 1999. [DOI: 10.1016/s1042-3699(20)30943-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Martín-Granizo R, Naval L, Costas A, Goizueta C, Rodriguez F, Monje F, Muñoz M, Diaz F. Use of buccal fat pad to repair intraoral defects: review of 30 cases. Br J Oral Maxillofac Surg 1997; 35:81-4. [PMID: 9146863 DOI: 10.1016/s0266-4356(97)90680-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The buccal fat pad has been frequently used for the closure of oro-antral and oro-nasal communications. There are a few studies in the literature reporting its use in defects secondary to tumoral resections. In this paper we consider both the anatomical basis and the surgical technique. We also review 30 cases, used for the repair of 15 defects due to tumoral resections, 8 to maxillary cysts, 6 to communications and 1 secondary to a postraumatic defect. It has been successful in 28 of the 29 patients, with a complete epithelization of the flap, even in 4 cases with partial necrosis of the pad. It is an acceptable type of reconstruction, versatile and of a simple surgical technique. However, its use is limited to small or medium defects, being sometimes scarce.
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Affiliation(s)
- R Martín-Granizo
- Department of Oral and Maxillofacial Surgery, University Hospital de la Princesa, Autónoma University of Madrid, Spain
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Salins PC, Kishore SK. Anteriorly based palatal flap for closure of large oroantral fistula. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 82:253-6. [PMID: 8884821 DOI: 10.1016/s1079-2104(96)80348-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A technique for closure of large oroantral fistula as a lateral transposition flap with an anteriorly based palatal flap is described. Mucoperiosteum of the posterior third of the hard palate, which is more yielding, is raised to bridge large defects without leaving any considerable exposed raw area. The technique is particularly useful in the correction of defects at the tuberosity region.
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Affiliation(s)
- P C Salins
- Department of Maxillofacial and Reconstructive Surgery, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, India
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41
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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; discussion 775-6. [PMID: 7595791 DOI: 10.1016/0278-2391(95)90329-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This report evaluates the use of a pedicled buccal fat pad graft for closure of oroantral fistulae. MATERIALS AND METHODS Fourteen patients with oroantral communications, ranging from 8 to 20 mm in diameter, were treated by the use of a pedicled buccal fat pad graft. RESULTS The procedure was successful in 13 of 14 patients. Postoperatively, the orally exposed fat gradually was transformed into a granulation-like tissue and epithelization developed within 3 weeks. CONCLUSION It was concluded that the procedure has wide application and a high degree of success.
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Affiliation(s)
- Y Hanazawa
- Department of Oral Surgery, Kawatetsu Chiba-Hospital, Japan
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42
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Ferraro NF, August M. Reconstruction Following Resection for Maxillofacial Tumors. Oral Maxillofac Surg Clin North Am 1993. [DOI: 10.1016/s1042-3699(20)30697-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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