The Buccal Myomucosal Flap For Reconstruction In Oral Cavity Cancers

Abstract

Objective: We aimed to review our data about the functional outcomes of the buccinator myomucosal flap used for head and neck reconstruction after oncologic ablative surgery. Methods: Retrospective chart analysis was performed of 15 patients between the ages 52 and 78 years (mean age 66 years) who had buccinator myomucosal flaps for oral cavity reconstruction after tumor ablation. All the resections and reconstructions were performed by the first author (BK) at two tertiary referral centers. The demographic feature of the patients, anatomical subsites of the cancer, operation type, flap raising time, total operation time, blood loss during flap harvesting, wound problems and other postoperative complications , decannulation time and postoperative oral feeding time were collected from the patients`patients`medical charts. Results: One patient had minimal distal flap loss. There was no need for additional surgery for this patient. Two patients had partial wound dehiscence, which was resutured in the operating theatre. The donor sites were closed primarily in all cases. One of the patients had wound dehiscence in donor site which healed by secondary intention. Mean flap size was 7x3.2 cm. All flaps needed a second operation for pedicle separation due to the pedicled flap nature. All separations of pedicles were performed using sedation and adequate analgesia in operating theatre without general anesthesia. Mean separation time was 12 days after the first surgery. Three patients had tracheostomy and the mean decannulation time was three days for those. Soft diet was started in the postoperative 2nd day in all patients. However, mean postoperative oral feeding time without any nasogastric tube assistance was five (3-9 days) days. Mean flap harvesting time was 35 minutes (25-49 minutes). Mean intraoperative blood loss during flap harvesting was 25 ml (20-40 ml).