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Revista Española de Cirugía Oral y Maxilofacial
versión On-line ISSN 2173-9161versión impresa ISSN 1130-0558
Resumen
CUESTA GIL, M. et al. Reconstruction of palatal defects with the buccinator muscle flap. Rev Esp Cirug Oral y Maxilofac [online]. 2005, vol.27, n.4, pp.206-215. ISSN 2173-9161.
Defects of the palate that are of a significant size require reconstruction with local or distant flaps in order to avoid important functional sequelae such as oronasal regurgitation and rhinolalia. The buccinator muscle flap, described by Bozola in 1989 for closing palatal fistulas and for reconstruction of the soft and hard palate, represents an important therapeutic alternative for this type of defect. In this work we present an anatomic-clinical description and the surgical technique with the myomucosal flap of buccinator muscle, as well as a small series of patients operated on in the Gregorio Marañon Hospital from the year 2000 to the year 2004. Of a total of 12 patients with palatal defects that were reconstructed using this flap, 4 were men and 8 were women. The defects in 5 cases were located in the hard palate and 7 were located in the soft palate. Primary reconstruction was carried out following oncological resectioning in 10 cases, while in 1 case secondary reconstruction was carried out after failure with a temporalis muscle flap, and in another patient it was used to cover a preprosthetic bone graft. The aesthetic and functional results were excellent in 10 out of 12 cases. The most common complication was dehiscence of the suture which occurred in five cases, three of which were resolved spontaneously and in another two cases it was necessary to re-operate. The buccinator muscle strikes us an interesting reconstruction technique for defects of the palate. It represents a surgical method that is simple and hardly aggressive, with very few sequelae and good results. It can also be used for resolving defects of the lip, tongue, jugal mucosa and of the orbits, as well as for cases of velopalatal insufficiency.
Palabras clave : Buccinator myomucosal flap; Palate; Reconstruction.