The myo-mucosal buccinator island flap:: indications and limits of the reconstruction of substance losses of the buccal cavity and the oropharynx

Objective: To outline the indications and limits of the myo-mucosal buccinator island flap based on the facial artery in the reconstruction of deficits of the buccal cavity and lateral wall of the oropharynx following oncologic resection or radionecrosis. Method: We retrospectively studied 40 patients. Flap is raised using a modified technique without doppler or skin incision to identify the facial artery. This study identifies causes for failure and limits and indications for this flap. Results: We found a failure rate of 10% and an identical fistula rate. On the other hand success rate is over 95% when (1) permeability of the artery is confirmed preoperatively in post-neck dissection or post-radiation therapy patients and (2) the deficit does not cross the midline. Conclusion: The myo-mucosal buccinator flap is a reliable technique. When specific indications are followed and the flap raised appropriately, the success rate is 95%.