A T-Shaped Musculomucosal Buccal Flap Method for Cleft Palate Surgery

Maeda, Katsuhide; Ojimi, Hiroyuki; Utsugi, Ryuichi; Ando, Shinichiro

doi:10.1097/00006534-198706000-00006

Cited by 72 publications

(33 citation statements)

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“…To this end, we employ an algorithm consisting of (1) relaxing incisions, (2) a complete intravelar veloplasty, (3) "total release" of the tensor aponeurosis at the level of the hamulus, (4) circumferential dissection of the greater palatine neurovascular bundle with osteotomy of the bony foramina when necessary, and (5) ADM placement when needed to either augment a tenuous repair or close a defect in the nasal lining. When ADM is employed, an ultrathin (6/1000 to 12/1000 in.…”

Section: Minimizing Fistula Formation After Palatoplastymentioning

confidence: 99%

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Acellular Dermal Matrix in Palatoplasty

Losee

Smith

2011

Aesthetic Surgery Journal

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The primary goal of palatoplasty is to allow normal speech through the correction of velopharyngeal incompetence. Failure to accomplish a tension-free, watertight closure predisposes the palatoplasty patient to postoperative fistula formation. Fistulas may in turn contribute to velopharyngeal incompetence. Reported fistula rates vary widely, ranging from 0% to greater than 70%; recurrence rates after attempted repair approach 65% in some series. These lesions therefore represent a significant clinical burden. Acellular dermal matrix materials have been introduced into various phases of palatoplasty as a strategy to augment repairs and minimize postoperative fistula formation, as well as repair fistulas when they do occur. In this article, the authors review the existing literature regarding acellular dermal matrix in palatoplasty and describe their own algorithm and results for primary and secondary palatoplasty in which acellular dermal matrix plays a central role.

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Section: Minimizing Fistula Formation After Palatoplastymentioning

confidence: 99%

“…2 The definitive repair of a palatal fistula is an endeavor not to be taken lightly. The incidence of cleft palate fistulas reportedly ranges from 0% to 76%, [3][4][5] with a recurrence rate nearing 65% in one study. 6 Acellular dermal matrix (ADM) is now being employed in multiple facets of palatoplasty.…”

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confidence: 92%

Acellular Dermal Matrix in Palatoplasty

Losee

Smith

2011

Aesthetic Surgery Journal

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“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][33][34][35]37 Rayner, in 1984, 17 mentioned several possible applications yet to be explored. Tezel et al 33 have restricted the use of CBMMF to the lower vermillion, gingivobuccal sulcus, mouth floor, and anterior maxillary defect reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 Although authors advocated wide use, they shared the opinion that some indications remained open to further investigation. So Maeda et al 19 developed a musculomucosal flap, Bozola et al 20 an axial buccal musculomucosal flap based on the buccal artery that branches from the internal maxillary artery. These flaps have the tendency of limited rotation or impairment of facial nerve function.…”

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confidence: 99%

Six Years Clinical Experience With the Dorsally Pedicled Buccal Musculomucosal Flap

Landes¹,

Seitz²,

Ballon³

et al. 2009

Annals of Plastic Surgery

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A dorsal pedicled buccal musculomucosal flap was developed to reconstruct medium-sized intraoral defects, too large for primary closure if major functional and esthetic impairment is to be avoided. Although free flaps, axial, or perforator flaps are excellent in large defects, they may not provide mucosal sensitivity, motility, volume, and texture to replace lost structures with similar tissue. Twenty-five flaps were performed in 24 patients, 1(bilateral) up to a flap-size of 60 x 35 mm, in average 45 x 34 mm. Reconstructed became the lateral mouth floor, lateral oral vestibule, lateral tongue margin, the oropharynx, hard and soft palate. Partial necrosis occurred in 1 flap, 22 (92%) patients recovered with good objective as subjective speech and swallowing, esthetics, and if necessary prosthetic rehabilitation. The donor site was closed primarily, mimics and mouth opening resolved after less than 3 months. The parotid duct had to be marsupialized in large flap preparations, never provoking stasis or infection. The 2-point sensitivity of the flaps was in average equal to the nonoperated mucosa in intraindividual correlation and the flaps lost in average 10% of their original size; 5 (21%) had weakness inflating their cheeks postoperatively. The results indicate dorsal pedicled buccal musculomucosal flap to be reliable and technically easy for reconstructing lateral intraoral, medium-sized defect that yields sensitivity, merely risking occasional buccal muscle weakness but facilitating the rehabilitation of oral function.

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“…Historicamente, o estudo do retalho partiu de um debate coloquial entre amigos, o autor e Chem 23 , quando o primeiro manifestou a impossibilidade de corrigir fistulas de palato com retalho microcirúrgico do dorso do pé com pedículo na artéria pediosa, pelas dificuldades que a técnica apresentava para cirurgiões que não faziam microcirurgias, como o próprio autor. E manifestou a necessidade de procurar outras soluções, complementando estudos prévios que buscavam obter melhor função e fechamento do palato com o mínimo de sequelas [24][25][26][27][28] .…”

Section: A B C D Eunclassified

Correction of palatine fistulas with a musculo-mucosal buccinator flap: results of 6 cases after 27 years

Bozola¹

2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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Introdução: O retalho miomucoso de músculo bucinador, descrito em 1989, pode ser utilizado para corrigir fístulas palatinas, fissuras com alongamento do palato mole ou cobrir áreas cruentas após ressecções de tumores. Métodos: Trata-se da análise do resultado após 27 anos de 6 casos de pacientes operados no Hospital de Base e na Santa Casa de São José do Rio Preto, no período de 1984 a 1989, e reavaliados em 2016, nos quais foram realizados retalhos miomucosos de bucinador para correção de fissura palatina. Resultados: Dos 36 casos operados, 6 foram reavaliados após 27 anos, dos quais 5 trataram-se de correção primária e 1 de correção secundária (fístula após fechamento de fissura palatina). Todos os casos obtiveram resultados satisfatórios no crescimento maxilar, na correção da fistula palatina e na função da fala. Conclusão: Apesar de estatisticamente não significativo, o presente estudo demonstrou que o retalho miomucoso de músculo bucinador para correção e alongamento do palato é um procedimento adequado, com resultados de crescimento maxilar normal ou próximo disso e fala praticamente normal, mesmo sem adequado tratamento fonoaudiológico. ■ RESUMO

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A T-Shaped Musculomucosal Buccal Flap Method for Cleft Palate Surgery

Cited by 72 publications

References 0 publications

Acellular Dermal Matrix in Palatoplasty

Acellular Dermal Matrix in Palatoplasty

Six Years Clinical Experience With the Dorsally Pedicled Buccal Musculomucosal Flap

Correction of palatine fistulas with a musculo-mucosal buccinator flap: results of 6 cases after 27 years

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