title: Inferiorly based buccinator myomucosal island flap in oral and pharyngeal reconstruction. Four techniques to increase its application.
abstract: BACKGROUND
  Reconstruction of oral and pharyngeal defects after pathologic resections with the same tissue is an optimal and ideal target. Islanded variety of inferiorly pedicled facial artery musculomucosal flap, in which facial artery and vein are skeletonized (referred to as inferiorly based BUMIF), is suitable for reconstruction of medium-sized mucosal defects.
  
  
  METHODS
  In this article, with four cases, modifications of this flap are demonstrated in reconstruction of large intraoral and oropharyngeal defects and coverage of alveolar ridge in the mandible.
  
  
  CONCLUSIONS
  In some situations, there is a need for more mucosal paddle, longer vascular pedicle and more adaptation to the recipient bed.
  
  
  CONCLUSIONS
  Relocating Stensen's duct increases the mucosal paddle with cranial extension of superior limit while differential incision of the mucosa and buccinator muscle in mandibular vestibule extend the lower limit of this flap. Bone suture is a good complementary technique when this flap is used for coverage of mandibular alveolar ridge. Inferiorly based BUMIF with added length is indicated for oropharyngeal and contralateral mouth floor reconstructions.
authors.affiliation: Oral and Maxillofacial Diseases Research Center, Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: rahpeymaa@mums.ac.ir.
authors.forename: Amin
authors.initials: A
authors.lastname: Rahpeyma
authors.affiliation: Dental Research Center, Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: khajehahmadis@mums.ac.ir.
authors.forename: Saeedeh
authors.initials: S
authors.lastname: Khajehahmadi
keywords: Buccinator flap; Facial artery; Oral cavity reconstruction; Oropharyngeal reconstruction