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BMC Geriatrics

Volume 10 Supplement 1

de Senectute: Age and Health Forum

Open Access

The buccal fat pad in recostruction of malignant lesions of the oral cavity: our experience on 31 cases

  • M Giudice1,
  • A Giudice1,
  • W Colangeli1 and
  • M G Cristofaro1
BMC Geriatrics201010(Suppl 1):A59

https://doi.org/10.1186/1471-2318-10-S1-A59

Published: 19 May 2010

Background

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.

Figure 1

Results

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).

Table 1

Pz. Age

Site

Size (cm) max. diameters

Healing

Complications

76

BM

4

RETRACTION

L IMITED ORAL OPENING

65

HP+SP

5

APPROPRIATE

NONE

72

BM

3

APPROPRIATE

NONE

78

HP+GB

5

RETRACTION

L IMITED ORAL OPENING

60

HP

3

APPROPRIATE

NONE

75

RMT

5

RETRACTION

L IMITED ORAL OPENING

60

HP+SP

4

APPROPRIATE

NONE

65

HP

4

APPROPRIATE

NONE

48

HP+SP

5

APPROPRIATE

OROANTRAL FISTULA

45

RMT

3

APPROPRIATE

NONE

68

HP

3

APPROPRIATE

NONE

72

HP+SP

5

APPROPRIATE

NONE

62

HP

3

APPROPRIATE

NONE

59

HP

3

APPROPRIATE

NONE

51

BM

2

APPROPRIATE

NONE

66

HP+SP

5

APPROPRIATE

NONE

70

BM

2

APPROPRIATE

NONE

43

HP

2

APPROPRIATE

NONE

67

HP

3

APPROPRIATE

NONE

66

BM+GB

4

RETRACTION

L IMITED ORAL OPENING

68

BM

5

RETRACTION

L IMITED ORAL OPENING

74

RMT

4

APPROPRIATE

NONE

73

BM+GB

5

RETRACTION

L IMITED ORAL OPENING

72

BM

4

RETRACTION

PARTIAL L IMITED ORAL OPENING

64

HP

3

APPROPRIATE

NONE

66

BM

3

APPROPRIATE

NONE

70

BM+GB

5

RETRACTION

PARTIAL L IMITED ORAL OPENING

67

HP

4

APPROPRIATE

PARTIAL L IMITED ORAL OPENING

53

RMT

4

RETRACTION

PARTIAL L IMITED ORAL OPENING

71

HP+SP

5

DELAYED

COMPLETE LOSS

68

HP

4

APPROPRIATE

PARTIAL LOSS

HP: hard palate; sp:soft palate; bm: buccal mucosa; gb: gingivobuccal sulcus; rmt: retromolar tritone

Figure 2

Conclusions

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.

Authors’ Affiliations

(1)
Department of Maxillo-Facial Surgery (Head: Mario Giudice), “Magna Graecia” University

References

  1. Rapidis AD, Alexandridis CA, Eleftheriadis E, Angelopoulos AP: The use of the buccal fat pad for reconstruction of oral defects: Review of the literature and report of 15 cases. Oral Maxillofac Surg. 2000, 58: 158-63.View ArticleGoogle Scholar
  2. Amin MA, Bailey BM, Swinson B, Witherow H: Use of the buccal fat pad in the reconstruction and prosthetic rehabilitation of oncological maxillary defects. Br J Oral Maxillofac Surg. 2005, 43: 148-54. 10.1016/j.bjoms.2004.10.014.PubMedView ArticleGoogle Scholar

Copyright

© Giudice et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.

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