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The buccal fat pad in recostruction of malignant lesions of the oral cavity: our experience on 31 cases
BMC Geriatrics volume 10, Article number: A59 (2010)
The use of the Buccal Fat Pad (BFP) as a pedicled graft in the closure of intra-oral defects after oncological resections has gained in popularity, it is probably due to the ease of access, the rich blood supply and the low morbidity. The purpose of this study is to show our clinical experience and the results related to the use of the BFP in the repair selective malignant lesions of the oral cavity.
Material and methods
This study included a series of 31 patients, from January 2001 to January 2009, with BFP primary reconstruction after medium intraoral malignant lesions excision. After tumors excision, the BFP was gently exposed in the region of the molars by blunt dissection with the goal of keeping the fascial envelope intact and to preserve BFP vascular supply. The graft is then sutured covering the defect margins by interrupted resorbable sutures (Figure 1). The success criterion was the complete epithelialization of the graft and the absence of the graft’s infection and fistulae occurrences. All the patients underwent primary closure of defects with the buccal fat pad. Four patients who underwent the operation also had adjuvant radiotherapy. Patients underwent one year follow-up.
All intraoral defects were adequately repaired but there was partial loss of the BFP in one case and complete loss in another (Table 1). Patients with an uneventful immediate postoperative period had signs of BFP epithelialization by the end of the first week. One month later, most of the patients had the BFP replaced by a thin whitish streak covered by normal mucosa, with very minimal fibrosis. The mouth opening was satisfactory in 21 patients, including those who received adjuvant radiotherapy. The BFP was epithelialized within 3–4 weeks and no additional surgery was required (Figure 2).
In conclusion we consider the BFP an ideal choice for the reconstruction of medium intraoral defects especially in post-oncologic cases, where the morbidity and the failure rate of reconstruction must be very low. Even more radiotherapy if necessary, can begin early, due to fast epithelialization process.
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Giudice, M., Giudice, A., Colangeli, W. et al. The buccal fat pad in recostruction of malignant lesions of the oral cavity: our experience on 31 cases. BMC Geriatr 10, A59 (2010). https://doi.org/10.1186/1471-2318-10-S1-A59
- Oral Cavity
- Malignant Lesion
- Adjuvant Radiotherapy
- Oncological Resection
- Defect Margin