How I do it: Head and neck and plastic surgery: Reconstruction of the floor of the mouth by means of an anteriorly based buccinator myomucosal island flap

Pedicled facial buccinator (FAB) flap: A new flap for reconstruction of skull base defects

“…The facial artery and vein are in close proximity at the angle of the mandible, but diverge superiorly 15. The facial vein is generally located 1 to 1.5 cm (11 mm 8 ) posterior to the facial artery at the midbuccinator level 11. As expected, venous anatomy displays increased variability compared to the arterial system 15…”

“…Variations of a buccinator flap based on the facial artery10, 11, 15, 17–20 have been described by multiple authors and will not be elucidated upon. The basis of the FAB flap most closely resembles the buccinator myomucosal reverse flow island flap reported in 1999 by Zhao et al10 Similarly, Fan et al21 described the use of reversed buccinator musculomucosal flaps for reconstruction of defects resulting from resection of nasal inverted papillomas.…”

“…The basis of the FAB flap most closely resembles the buccinator myomucosal reverse flow island flap reported in 1999 by Zhao et al10 Similarly, Fan et al21 described the use of reversed buccinator musculomucosal flaps for reconstruction of defects resulting from resection of nasal inverted papillomas. Buccal myomucosal flaps have historically been used to reconstruct oral cavity defects,11, 15, 18, 20, 22–25 but have also been employed to repair defects of the nasal septum,18, 26 lower lip,25 conjunctiva, and midface 10. The axial arterial supply of the buccal myomucosal flap is the facial/angular artery, although anastomosis/contributions from the infraorbital, dorsal nasal, and ophthalmic arteries cannot be ignored.…”

“…1). It is located superficial to, and at the anterior aspect of the buccinator,11 deep to facial mimetic musculature10, 12 and 1 to 1.6 cm 8 (mean 1.38) from the oral comissure 10. The facial artery supplies the buccinator through inferior and anterior buccal branches10 and ascends in the nasofacial groove to the medial canthus as the angular artery 10, 13.…”

Buccinator-based myomucosal flaps in intraoral reconstruction: A review and new classification

“…Anteriorly based buccinator myomucosal flap was introduced by Carstens et al . [3233] They used anteriorly based in contrast with posteriorly based flap that was introduced by Bozola et al . Nowadays, anteriorly based buccinator myomucosal flap should be used just for buccinator flaps, in which the pedicle is near oral commissure and superior, posterior, and inferior margins are incised.…”