title: Lateral Oropharyngeal Wall Coverage with Buccinator Myomucosal and Buccal Fat Pad Flaps.
abstract: BACKGROUND
  Reconstruction of oropharyngeal defects after resection of oropharyngeal cancer is a significant challenge. The purpose of this study is to introduce reconstruction using a combination of a buccinator myomucosal flap and a buccal fat pad flap after cancer excision and to discuss the associated anatomy, surgical procedure, and clinical applications.
  
  
  METHODS
  In our study, a combination of a buccinator myomucosal flap with a buccal fat pad flap was utilized for reconstruction after resection of oropharyngeal cancer, performed between 2013 and 2015. After oropharyngectomy, the defect with exposed vital structures was noted. A buccinator myomucosal flap was designed and elevated after an assessment of the flap pedicle. Without requiring an additional procedure, a buccal fat pad flap was easily harvested in the same field and gently pulled to obtain sufficient volume. The flaps were rotated and covered the defect. In addition, using cadaver dissections, we investigated the feasibility of transposing the flaps into the lateral oropharyngeal defect.
  
  
  RESULTS
  The reconstruction was performed in patients with squamous cell carcinoma. The largest tumor size was 5 cm×2 cm (length×width). All donor sites were closed primarily. The flaps were completely epithelialized after four weeks, and the patients were followed up for at least six months. There were no flap failures or postoperative wound complications. All patients were without dietary restrictions, and no patient had problems related to mouth opening, swallowing, or speech.
  
  
  CONCLUSIONS
  A buccinator myomucosal flap with a buccal fat pad flap is a reliable and valuable option in the reconstruction of oropharyngeal defects after cancer resection for maintaining functionality.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Bok Ki
authors.initials: BK
authors.lastname: Jung
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Song
authors.affiliation: Department of Otorhinolaryngology, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Se-Heon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Won Jai
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Tai Suk
authors.initials: TS
authors.lastname: Roh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Lew
keywords: Oropharyngeal neoplasms; Reconstructive surgical procedures; Surgical flap