title: Use of the buccinator musculomucosal flap for bone coverage in primary cleft palate repair.
abstract: BACKGROUND
  Cleft palate is one of the most common congenital malformations in the maxillofacial region. After a cleft palate repair, surgeons must deal with the transverse growth restriction and palatal fistulas caused by scar tissue on the raw bone surface around the hard palate. This report describes the technique of the buccinator musculomucosal flap procedure performed together with repair of the cleft palate. The objective is to cover exposed bone areas of the hard palate to decrease scar contraction and subsequent transverse maxillary growth restriction, as well as tension at the closure.
  
  
  METHODS
  From August 2009 to February 2012, 15 patients underwent the buccinator musculomucosal flap procedure. First, the cleft palate was repaired by mucoperiosteal flaps, resulting in wide and raw bone surfaces around the hard palate. The outline of the flap was marked on the buccal mucosa. Grounding on the exposed bone areas around the hard palate, the authors designed widths of flaps ranging from 1.5 to 2.5 cm. These flaps were elevated from the buccopharyngeal fascia and turned 90° to cover the raw hard palate bone surfaces. The donor sites were closed by direct suture.
  
  
  RESULTS
  The follow-up period was 1-26 months (average, 10 months). No complications were found in any patient who underwent the procedure, and no fistulas occurred in the midline of the palate. No patients experienced complications related to the donor sites. No trismus or other dysfunction related to mouth movement was observed.
  
  
  CONCLUSIONS
  The buccinator musculomucosal flap is a convenient and safe flap procedure with fewer donor-site complications. This procedure also has significant potential for improving maxilla growth and reducing the secondary complications that often can result from cleft palate repair.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33, Ba-Da-Chu Road, Beijing, 100144, China.
authors.forename: Zengjie
authors.initials: Z
authors.lastname: Yang
authors.forename: Liqiang
authors.initials: L
authors.lastname: Liu
authors.forename: Jincai
authors.initials: J
authors.lastname: Fan
authors.forename: Wenlin
authors.initials: W
authors.lastname: Chen
authors.forename: Siqi
authors.initials: S
authors.lastname: Fu
authors.forename: Zhuming
authors.initials: Z
authors.lastname: Yin
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D002681:China; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D005152:Facial Muscles / Q000637:transplantation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult