Buccinator myomucosal flap for oral and oropharyngeal reconstruction: a series of 121 patients.

Small-to-moderate oral and oropharyngeal defects can be repaired using various techniques, including primary closure, skin grafts, intraoral flaps, and extraoral flaps. Intraoral options include the buccal fat pad, palatal flap, tongue flap, and buccinator myomucosal flap (BMMF). Each flap has advantages and limitations in its applicability, due to anatomical and functional factors. This retrospective study evaluated 121 patients who underwent oral and oropharyngeal reconstruction using the BMMF; 102 had malignant tumours, two had benign tumours, 14 had cleft lip and palate, and three had oronasal/antral communications. The reconstruction site was the tongue in 40 cases, oropharynx in 18, cleft palate in 14, maxillary alveolus in 11, floor of the mouth in 10, hard palate in nine, labial mucosa in eight, mandibular alveolus in seven, oronasal/antral communication in three, and lower lip vermilion in one. Overall, 128 flaps were harvested and transferred successfully, with only two instances of minor peripheral necrosis. The flap elevation technique was straightforward, with vascular integrity remaining highly stable. The intraoral texture, colour, and bulk were well matched. However, the defect size that could be repaired was limited because the flap width had to allow primary donor site closure at maximum mouth opening, thereby maintaining low donor site morbidity. The study findings show the BMMF to be a versatile and reliable local flap for the repair of small-to-moderate oral and oropharyngeal defects. This study summarizes the surgical anatomy, technical considerations, indications, and outcomes based on experience in 121 patients.