Skip to main content
SpringerLink
Log in

Buccinator Myomucosal Flap in Cleft Palate Repair: The SOBRAPAR Hospital Experience

  • Chapter
  • First Online:
Cleft Lip and Palate Treatment

Abstract

In 1989, Bozola et al. (1989) published the first anatomic description of a posterior buccinator myomucosal flap based on the buccal branch of the internal maxillary artery. Different types and technical modifications of the buccinator myomucosal flap have been described reflecting its versatility for numerous reconstructive applications (Bozola et al. 1989; Vaira et al. 2017; Jowett et al. 2017; Ayad and Xie 2015; Rahpeyma and Khajehahmadi 2015a, 2013; Franco et al. 2014; Massarelli et al. 2013; Zhao et al. 1999; Pribaz et al. 1992; Carstens et al. 1991). Based on a dense vascular network between the facial artery and the internal maxillary artery there are variations as the posteriorly based flap (buccal branch of the internal maxillary artery, which enters its lateral aspect just anterior to the pterygomandibular raphe), the superiorly and antero-inferiorly based flaps with direct (facial artery musculomucosal [FAMM] flap) or retrograde flow (reverse-flow facial artery buccinator flap), and the island flap (a vascular island variant of FAMM flap, in which the facial artery and vein are skeletonized) (Bozola et al. 1989; Vaira et al. 2017; Jowett et al. 2017; Ayad and Xie 2015; Rahpeyma and Khajehahmadi 2015a, 2013; Franco et al. 2014; Massarelli et al. 2013; Zhao et al. 1999; Pribaz et al. 1992; Carstens et al. 1991).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abdaly H, Omranyfard M, Ardekany MR, Babaei K. Buccinator flap as a method for palatal fistula and VPI management. Adv Biomed Res. 2015;4:135.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Abdel-Aziz M. The use of buccal flap in the closure of posterior post-palatoplasty fistula. Int J Pediatr Otorhinolaryngol. 2008;72:1657–61.

    Article  PubMed  Google Scholar 

  • Abdel-Aziz M, El-Hoshy H, Ghandour H. Treatment of velopharyngeal insufficiency after cleft palate repair depending on the velopharyngeal closure pattern. J Craniofac Surg. 2011;22:813–7.

    Article  PubMed  Google Scholar 

  • Adenwalla HS, Narayanan PV, Rajshree CJ. The history and evolution of cleft surgery in India. Indian J Plast Surg. 2005;38:188–91.

    Article  Google Scholar 

  • Ahl R, Harding-Bell A, Wharton L, Jordan A, Hall P. The Buccinator mucomuscular flap: an in-depth analysis and evaluation of its role in the management of velopharyngeal dysfunction. Cleft Palate Craniofac J. 2016;53:e177–84.

    Article  PubMed  Google Scholar 

  • Alfwaress FS, Khwaileh FA, Khamaiseh ZA. The speech language Pathologist’s role in the Cleft lip and palate team. J Craniofac Surg. 2015;26:1439–42.

    Article  PubMed  Google Scholar 

  • Alsalman AK, Algadiem EA, Alwabari MS, Almugarrab FJ. Single-layer Closure with tongue flap for palatal fistula in Cleft palate patients. Plast Reconstr Surg Glob Open. 2016;4:e852.

    Article  PubMed  PubMed Central  Google Scholar 

  • Armour A, Fischbach S, Klaiman P, Fisher DM. Does velopharyngeal closure pattern affect the success of pharyngeal flap pharyngoplasty? Plast Reconstr Surg. 2005;115:45–52.

    CAS  PubMed  Google Scholar 

  • Ashtiani AK, Emami SA, Rasti M. Closure of complicated palatal fistula with facial artery musculomucosal flap. Plast Reconstr Surg. 2005;116:381–6. discussion 387–388

    Article  CAS  PubMed  Google Scholar 

  • Ayad T, Xie L. Facial artery musculomucosal flap in head and neck reconstruction: a systematic review. Head Neck. 2015;37:1375–86.

    Article  PubMed  Google Scholar 

  • Bardach J, editor. Atlas of craniofacial and Cleft surgery, vol. 2. Philadelphia: Lippincott Raven; 1999.

    Google Scholar 

  • Bertolazi AN, Fagondes SC, Holff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese-language version of the Epworth sleepiness scale. Validation for use in Brazil. J Bras Pneumol. 2009;35:877–83.

    Article  PubMed  Google Scholar 

  • Bishop A, Hong P, Bezuhly M. Autologous fat grafting for the treatment of velopharyngeal insufficiency: state of the art. J Plast Reconstr Aesthet Surg. 2014;67:1–8.

    Article  CAS  PubMed  Google Scholar 

  • Bonanthaya K, Shetty P, Sharma A, Ahlawat J, Passi D, Singh M. Treatment modalities for surgical management of anterior palatal fistula: comparison of various techniques, their outcomes, and the factors governing treatment plan: a retrospective study. Natl J Maxillofac Surg. 2016;7:148–52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bozola AR, Gasques JA, Carriquiry CE, Cardoso de Oliveira M. The buccinator musculomucosal flap: anatomic study and clinical application. Plast Reconstr Surg. 1989;84:250–7.

    Article  CAS  PubMed  Google Scholar 

  • Bykowski MR, Naran S, Winger DG, Losee JE. The rate of Oronasal fistula following primary Cleft palate surgery: a meta-analysis. Cleft Palate Craniofac J. 2015;52:e81–7.

    Article  PubMed  Google Scholar 

  • Carlson LC, Hatcher KW, Tomberg L, Kabetu C, Ayala R, Vander Burg R. Inequitable access to timely Cleft palate surgery in low- and middle-income countries. World J Surg. 2016;40:1047–52.

    Article  PubMed  Google Scholar 

  • Carstens MH, Stofman GM, Sotereanos GC, Hurwitz DJ. A new approach for repair of oro-antral-nasal fistulae. The anteriorly based buccinator myomucosal island flap. J Craniomaxillofac Surg. 1991;19:64–70.

    Article  CAS  PubMed  Google Scholar 

  • Chen GF, Zhong LP. A bilateral musculomucosal buccal flap method for cleft palate surgery. J Oral Maxillofac Surg. 2003;61:1399–404.

    Article  PubMed  Google Scholar 

  • Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ, Wang YC, Guilleminault C. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev. 2016; doi:10.1016/j.smrv.2016.10.004. [Epub ahead of print]

  • Chung F, Abdullah HR, Liao P. STOP-bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. 2016;149:631–8.

    Article  PubMed  Google Scholar 

  • Cohen SR, Kalinowski J, LaRossa D, Randall P. Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management. Plast Reconstr Surg. 1991;87:1041–7.

    Article  CAS  PubMed  Google Scholar 

  • Collins J, Cheung K, Farrokhyar F, Strumas N. Pharyngeal flap versus sphincter pharyngoplasty for the treatment of velopharyngeal insufficiency: a meta-analysis. J Plast Reconstr Aesthet Surg. 2012;65:864–8.

    Article  PubMed  Google Scholar 

  • Denadai R, Samartine Junior H, Denadai R, Raposo-Amaral CE. The public recognizes plastic surgeons as leading experts in the treatment of congenital cleft and craniofacial anomalies. J Craniofac Surg. 2015a;26:e684–9.

    Article  PubMed  Google Scholar 

  • Denadai R, Muraro CA, Raposo-Amaral CE. Residents’ perceptions of plastic surgeons as craniofacial surgery specialists. J Craniofac Surg. 2015b;26:2334–8.

    Article  PubMed  Google Scholar 

  • Denadai R, Sabbag A, Raposo-Amaral CE, Filho JC, Nagae MH, Raposo-Amaral CA. Bilateral buccinator myomucosal flap outcomes in nonsyndromic patients with repaired cleft palate and velopharyngeal insufficiency. J Plast Reconstr Aesthet Surg. 2017;70:1598–1607.

    Google Scholar 

  • Deren O, Ayhan M, Tuncel A, Görgü M, Altuntaş A, Kutlay R, Erdoğan B. The correction of velopharyngeal insufficiency by Furlow palatoplasty in patients older than 3 years undergoing Veau-Wardill-Kilner palatoplasty: a prospective clinical study. Plast Reconstr Surg. 2005;116:85–93.

    Article  CAS  PubMed  Google Scholar 

  • Diah E, Lo LJ, Yun C, Wang R, Wahyuni LK, Chen YR. Cleft oronasal fistula: a review of treatment results and a surgical management algorithm proposal. Chung Gang Med J. 2007;30:529–37.

    Google Scholar 

  • Dias DK, Fernando PD, Dissanayake RD. Improvement of quality of speech in patients with velo-pharyngeal insufficiency corrected using a buccinator myomucosal flap. Ceylon Med J. 2016;61:130–4.

    Article  CAS  PubMed  Google Scholar 

  • Ecker HA. The use of the buccal flap in cleft palate repair. Plast Reconstr Surg Transplant Bull. 1960;25:235–9.

    Article  CAS  PubMed  Google Scholar 

  • Emory RE, Clay RP, Bite U, Jackson IT. Fistula formation and repair after palatal closure: an institutional perspective. Plast Reconstr Surg. 1997;99:1535–8.

    Article  PubMed  Google Scholar 

  • Fang L, Yang M, Wang C, Ma T, Zhao Z, Yin N, Wei L, Yin J. A clinical study of various buccinator musculomucosal flaps for palatal fistulae closure after cleft palate surgery. J Craniofac Surg. 2014;25:e197–202.

    Article  PubMed  Google Scholar 

  • Ferrari S, Ferri A, Bianchi B, Copelli C, Boni P, Sesenna E. Donor site morbidity using the buccinator myomucosal island flap. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:306–11.

    Article  PubMed  Google Scholar 

  • Fitzsimons DA. International confederation for cleft lip and palate and related craniofacial anomalies task force report: speech assessment. Cleft Palate Craniofac J. 2014;51:e138–45.

    Article  PubMed  Google Scholar 

  • Follmar KE, Yuan N, Pendleton CS, Dorafshar AH, Kolk CV, Redett RJ 3rd. Velopharyngeal insufficiency rates after delayed cleft palate repair: lessons learned from internationally adopted patients. Ann Plast Surg. 2015;75:302–5.

    Article  CAS  PubMed  Google Scholar 

  • Fonseca LB, Silveira EA, Lima NM, Rabahi MF. STOP-bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol. 2016;42:266–72.

    Article  PubMed  PubMed Central  Google Scholar 

  • Franco D, Rocha D, Arnaut M Jr, Freitas R, Alonso N. Versatility of the buccinator myomucosal flap in atypical palate reconstructions. J Craniomaxillofac Surg. 2014;42:1310–4.

    Article  PubMed  Google Scholar 

  • Freda N, Rauso R, Curinga G, Clemente M, Gherardini G. Easy closure of anterior palatal fistula with local flaps. J Craniofac Surg. 2010;21:229–32.

    Article  PubMed  Google Scholar 

  • Freedlander E, Jackson IT. The fate of buccal mucosal flaps in primary palatal repair. Cleft Palate J. 1989;26:110–2. discussion 112–113

    CAS  PubMed  Google Scholar 

  • Fukushiro AP, Trindade IE. Nasometric and aerodynamic outcome analysis of pharyngeal flap surgery for the management of velopharyngeal insufficiency. J Craniofac Surg. 2011;22:1647–51.

    Article  PubMed  Google Scholar 

  • Gart MS, Gosain AK. Surgical management of velopharyngeal insufficiency. Clin Plast Surg. 2014;41:253–70.

    Article  PubMed  Google Scholar 

  • Guerrero Santos J, Altamirano JT. The use of lingual flaps in repair of fistulae of the hard palate. Plast Reconstr Surg. 1966;38:123.

    Article  CAS  PubMed  Google Scholar 

  • Guerrero-Santos J, Fernandez JM. Further experience with tongue flap in cleft palate repair. Cleft Palate J. 1973;10:192–202.

    CAS  PubMed  Google Scholar 

  • Habib AS, Brennan PA. The Deepithelialized dorsal tongue flap for reconstruction of anterior palatal fistulae: literature review and presentation of our experience in Egypt. Cleft Palate Craniofac J. 2016;53:589–96.

    Article  PubMed  Google Scholar 

  • Hardwicke JT, Landini G, Richard BM. Fistula incidence after primary cleft palate repair: a systematic review of the literature. Plast Reconstr Surg. 2014;134:618e–27e.

    Article  CAS  PubMed  Google Scholar 

  • Henningsson G, Kuehn DP, Sell D, Sweeney T, Trost-Cardamone JE, Whitehill TL, Speech Parameters Group. Universal parameters for reporting speech outcomes in individuals with cleft palate. Cleft Palate Craniofac J. 2008;45:1–17.

    Article  PubMed  Google Scholar 

  • Hens G, Sell D, Pinkstone M, Birch MJ, Hay N, Sommerlad BC, Kangesu L. Palate lengthening by buccinator myomucosal flaps for velopharyngeal insufficiency. Cleft Palate Craniofac J. 2013;50:e84–91.

    Article  CAS  PubMed  Google Scholar 

  • Hill C, Hayden C, Riaz M, Leonard AG. Buccinator sandwich pushback: a new technique for treatment of secondary velopharyngeal incompetence. Cleft Palate Craniofac J. 2004;41:230–7.

    Article  CAS  PubMed  Google Scholar 

  • Hopper RA, Tse R, Smartt J, Swanson J, Kinter S. Cleft palate repair and velopharyngeal dysfunction. Plast Reconstr Surg. 2014;133:852e–64e.

    Article  CAS  PubMed  Google Scholar 

  • Jackson IT. Closure of secondary palatal fistulae with intraoral tissue and bone grafting. Brit J Plast Surg. 1972;25:73.

    Article  Google Scholar 

  • Jackson IT, McLennan G, Scheker LR. Primary veloplasty or primary palatoplasty: some preliminary findings. Plast Reconstr Surg. 1983;72:153–7.

    Article  CAS  PubMed  Google Scholar 

  • Jackson IT, Moreira-Gonzalez AA, Rogers A, Beal BJ. The buccal flap--a useful technique in cleft palate repair? Cleft Palate Craniofac J. 2004;41:144–51.

    Article  PubMed  Google Scholar 

  • Jagannathan M, Dixit V. Palatal lengthening following use of buccal myomucosal flap in primary palatoplasty-real or apparent? A study of physical variables. Eur J Plast Surg. 2004;26:414–8.

    Article  Google Scholar 

  • Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    Article  CAS  PubMed  Google Scholar 

  • Jowett N, Hadlock TA, Sela E, Toth M, Knecht R, Lörincz BB. Facial mimetic, cosmetic, and functional standardized assessment of the facial artery musculomucosal (FAMM) flap. Auris Nasus Larynx. 2017;44:220–6.

    Article  PubMed  Google Scholar 

  • Kaplan EN. Soft palate repair by levator muscle reconstruction and a buccal mucosal flap. Plast Reconstr Surg. 1975;56:129–36.

    Article  CAS  PubMed  Google Scholar 

  • Katzel EB, Shakir S, Naran S, MacIsaac Z, Camison L, Greives M, Goldstein JA, Grunwaldt LJ, Ford MD, Losee JE. Speech outcomes after clinically indicated posterior pharyngeal flap takedown. Ann Plast Surg. 2016;77:420–4.

    Article  CAS  PubMed  Google Scholar 

  • Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review. Sleep Med Rev. 2014;18:321–31.

    Article  PubMed  Google Scholar 

  • Khanna S, Dagum AB. Waltzing a facial artery musculomucosal flap to salvage a recurrent palatal fistula. Cleft Palate Craniofac J. 2012;49:750–2.

    Article  PubMed  Google Scholar 

  • Kobayashi S, Fukawa T, Hirakawa T, Maegawa J. The folded buccal musculomucosal flap for large palatal fistulae in cleft palate. Plast Reconstr Surg Glob Open. 2014;2:e112.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kummer AW. Speech evaluation for patients with cleft palate. Clin Plast Surg. 2014;41:241–51.

    Article  PubMed  Google Scholar 

  • Lahiri A, Richard B. Superiorly based facial artery musculomucosal flap for large anterior palatal fistulae in clefts. Cleft Palate Craniofac J. 2007;44:523–7.

    Article  PubMed  Google Scholar 

  • Lam DJ, Starr JR, Perkins JA, Lewis CW, Eblen LE, Dunlap J, Sie KC. A comparison of nasendoscopy and multiview videofluoroscopy in assessing velopharyngeal insufficiency. Otolaryngol Head Neck Surg. 2006;134:394–402.

    Article  PubMed  Google Scholar 

  • Lam E, Hundert S, Wilkes GH. Lateral pharyngeal wall and velar movement and tailoring velopharyngeal surgery: determinants of velopharyngeal incompetence resolution in patients with cleft palate. Plast Reconstr Surg. 2007;120:495–505.

    Article  CAS  PubMed  Google Scholar 

  • Lee JY, Alizadeh K. Spacer facial artery musculomucosal flap: simultaneous closure of oronasal fistulas and palatal lengthening. Plast Reconstr Surg. 2016;137:240–3.

    Article  CAS  PubMed  Google Scholar 

  • Logjes RJ, van den Aardweg MT, Blezer MM, van der Heul AM, Breugem CC. Velopharyngeal insufficiency treated with levator muscle repositioning and unilateral myomucosal buccinator flap. J Craniomaxillofac Surg. 2017;45:1–7.

    Article  PubMed  Google Scholar 

  • Ma L, Shi B, Li Y, Zheng Q. Velopharyngeal function assessment in patients with cleft palate: perceptual speech assessment versus nasopharyngoscopy. J Craniofac Surg. 2013;24:1229–31.

    Article  PubMed  Google Scholar 

  • Maeda K, Ojimi H, Utsugi R, Ando S. A T-shape musculomucosal buccal flap method for cleft palate surgery. Plast Reconstr Surg. 1987;79:888–96.

    Article  CAS  PubMed  Google Scholar 

  • Mahajan RK, Chhajlani R, Ghildiyal HC. Role of tongue flap in palatal fistula repair: a series of 41 cases. Indian J Plast Surg. 2014;47:210–5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mann RJ, Fisher DM. Bilateral buccal flaps with double opposing Z-plasty for wider palatal clefts. Plast Reconstr Surg. 1997;100:1139–43.

    Article  CAS  PubMed  Google Scholar 

  • Mann RJ, Neaman KC, Armstrong SD, Ebner B, Bajnrauh R, Naum S. The double-opposing buccal flap procedure for palatal lengthening. Plast Reconstr Surg. 2011;127:2413–8.

    Article  CAS  PubMed  Google Scholar 

  • Mann RJ, Martin MD, Eichhorn MG, Neaman KC, Sierzant CG, Polley JW, Girotto JA. The double opposing Z-Plasty plus or minus Buccal flap approach for repair of Cleft palate: a review of 505 consecutive cases. Plast Reconstr Surg. 2017;139:735e–44e.

    Article  CAS  PubMed  Google Scholar 

  • Massarelli O, Baj A, Gobbi R, Soma D, Marelli S, De Riu G, Tullio A, Giannì AB. Cheek mucosa: a versatile donor site of myomucosal flaps. Technical and functional considerations. Head Neck. 2013;35:109–17.

    Article  PubMed  Google Scholar 

  • McComb RW, Marrinan EM, Nuss RC, Labrie RA, Mulliken JB, Padwa BL. Predictors of velopharyngeal insufficiency after le fort I maxillary advancement in patients with cleft palate. J Oral Maxillofac Surg. 2011;69:2226–32.

    Article  PubMed  Google Scholar 

  • Mukherji MM. Cheek flap for short palates. Cleft Palate J. 1969;6:415–20.

    CAS  PubMed  Google Scholar 

  • Murrell GL, Requena R, Karakla DW. Oronasal fistula repair with three layers. Plast Reconstr Surg. 2001;107:143–7.

    Article  CAS  PubMed  Google Scholar 

  • Murthy J. Descriptive study of management of palatal fistula in one hundred and ninety-four cleft individuals. Indian J Plast Surg. 2011;44:41–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Muzaffar AR, Byrd HS, Rohrich RJ, Johns DF, LeBlanc D, Beran SJ, Anderson C, Papaioannou AA. Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair. Plast Reconstr Surg. 2001;108:1515–8.

    Article  CAS  PubMed  Google Scholar 

  • Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, Memtsoudis S, Mokhlesi B, Chung F. Validation of the STOP-bang questionnaire as a screening tool for obstructive sleep apnea among different populations: a systematic review and meta-analysis. PLoS One. 2015;10:e0143697.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Nakakita N, Maeda K, Ojimi H, Utsugi R, Maekawa J. The modified buccal musculomucosal flap method for cleft palate surgery. Plast Reconstr Surg. 1991;88:421–6.

    Article  CAS  PubMed  Google Scholar 

  • Park SW, Oh TS, Koh KS. Repeat double-opposing Z-Plasty for the Management of Persistent Velopharyngeal Insufficiency. Ann Plast Surg. 2016;77:626–9.

    Article  CAS  PubMed  Google Scholar 

  • Penna V, Bannasch H, Stark GB. The turbinate flap for oronasal fistula closure. Ann Plast Surg. 2007;59:679–81.

    Article  CAS  PubMed  Google Scholar 

  • Perkins JA, Lewis CW, Gruss JS, Eblen LE, Sie KC. Furlow palatoplasty for management of velopharyngeal insufficiency: a prospective study of 148 consecutive patients. Plast Reconstr Surg. 2005;116:72–80. discussion 81–84

    Article  CAS  PubMed  Google Scholar 

  • Pigott RW. The nasendoscopic appearance of the normal palatopharyngeal valve. Plast Reconstr Surg. 1969;43:19–24.

    Article  CAS  PubMed  Google Scholar 

  • Pigott RW, Bensen JF, White FD. Nasendoscopy in the diagnosis of velopharyngeal incompetence. Plast Reconstr Surg. 1969;43:141–7.

    Article  CAS  PubMed  Google Scholar 

  • Pribaz J, Stephens W, Crespo L, Gifford G. A new intraoral flap: Facial artery musculomucosal (FAMM) flap. Plast Reconstr Surg. 1992;90:421–9.

    Article  CAS  PubMed  Google Scholar 

  • Rahpeyma A, Khajehahmadi S. Buccinator-based myomucosal flaps in intraoral reconstruction: a review and new classification. Natl J Maxillofac Surg. 2013;4:25–32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rahpeyma A, Khajehahmadi S. Inferiorly based buccinator myomucosal island flap in oral and pharyngeal reconstruction. Four techniques to increase its application. Int J Surg Case Rep. 2015a;14:58–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rahpeyma A, Khajehahmadi S. Closure of huge palatal fistula in an adult patient with isolated cleft palate: a technical note. Plast Reconstr Surg Glob Open. 2015b;3:e306.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rahpeyma A, Khajehahmadi S. Donor site morbidity in buccinator-based myomucosal flaps: a retrospective study. Asian J Surg. 2016;40(3):210–4. doi:10.1016/j.asjsur.2015.10.010. [Epub ahead of print]

    Article  PubMed  Google Scholar 

  • Raposo-Amaral CE, Raposo-Amaral CA. Changing face of cleft care: specialized centers in developing countries. J Craniofac Surg. 2012;23:206–9.

    Article  PubMed  Google Scholar 

  • Raposo-do-Amaral CA. Bilateral buccinator myomucosal flap for the treatment of velopharyngeal insufficiency: preliminary results. Rev Bras Cir Plást. 2013;28:455–661.

    Google Scholar 

  • Robertson AG, McKeown DJ, Bello-Rojas G, Chang YJ, Rogers A, Beal BJ, Blake M, Jackson IT. Use of buccal myomucosal flap in secondary cleft palate repair. Plast Reconstr Surg. 2008;122:910–7.

    Article  CAS  PubMed  Google Scholar 

  • Rossell-Perry P, Arrascue HM. The nasal artery musculomucosal cutaneous flap in difficult palatal fistula closure. Craniomaxillofac Trauma Reconstr. 2012;5:175–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sadhu P. Oronasal fistula in cleft palate surgery. Indian J Plast Surg. 2009;42(Suppl):S123–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salimi N, Aleksejūnienė J, Yen EH, Loo AY. Fistula in Cleft lip and palate patients-a systematic scoping review. Ann Plast Surg. 2017;78:91–102.

    Article  CAS  PubMed  Google Scholar 

  • Seagle MB, Williams WN, Dixon-Wood V. Treatment of velopharyngeal insufficiency: fifteen-year experience at the University of Florida. Ann Plast Surg. 2016;76:285–7.

    Article  CAS  PubMed  Google Scholar 

  • Setabutr D, Roth CT, Nolen DD, Cervenka B, Sykes JM, Senders CW, Tollefson TT. Revision rates and speech outcomes following pharyngeal flap surgery for velopharyngeal insufficiency. JAMA Facial Plast Surg. 2015;17:197–201.

    Article  PubMed  Google Scholar 

  • Shetty R, Lamba S, Gupta AK. Role of facial artery musculomucosal flap in large and recurrent palatal fistulae. Cleft Palate Craniofac J. 2013;50:730–3.

    Article  PubMed  Google Scholar 

  • Shprintzen RJ, Golding-Kushner K. Evaluation of velopharyngeal insufficiency. Otolaryngol Clin N Am. 1989;22:519–36.

    CAS  Google Scholar 

  • Sie KC, Tampakopoulou DA, Sorom J, Gruss JS, Eblen LE. Results with Furlow palatoplasty in management of velopharyngeal insufficiency. Plast Reconstr Surg. 2005;108:17–25. discussion 26–29

    Article  Google Scholar 

  • Silva GE, Vana KD, Goodwin JL, Sherrill DL, Quan SF. Identification of patients with sleep disordered breathing: comparing the four-variable screening tool, STOP, STOP-bang, and Epworth sleepiness scales. J Clin Sleep Med. 2011;7:467–72.

    PubMed  PubMed Central  Google Scholar 

  • Smith DM, Vecchione L, Jiang S, Ford M, Deleyiannis FW, Haralam MA, Naran S, Worrall CI, Dudas JR, Afifi AM, Marazita ML, Losee JE. The Pittsburgh fistula classification system: a standardized scheme for the description of palatal fistulas. Cleft Palate Craniofac J. 2007;44:590–4.

    Article  PubMed  Google Scholar 

  • Sohail M, Bashir MM, Khan FA, Ashraf N. Comparison of clinical outcome of facial artery Myomucosal flap and tongue flap for Closure of large anterior palatal fistulas. J Craniofac Surg. 2016;27:1465–8.

    Article  PubMed  Google Scholar 

  • Sommerlad BC, Mehendale FV, Birch MJ, Sell D, Hattee C, Harland K. Palate re-repair revisited. Cleft Palate Craniofac J. 2002;39:295–307.

    Article  PubMed  Google Scholar 

  • Sullivan SR, Marrinan EM, Mulliken JB. Pharyngeal flap outcomes in nonsyndromic children with repaired cleft palate and velopharyngeal insufficiency. Plast Reconstr Surg. 2010;125:290–8.

    Article  CAS  PubMed  Google Scholar 

  • Vaira LA, Massarelli O, Gobbi R, Soma D, Dell’aversana Orabona G, Piombino P, De Riu G. Evaluation of discriminative sensibility in patient with buccinators myomucosal flap oral cavity reconstructions. Eur J Plast Surg. 2017; doi:10.1007/s00238-017-1277-z.

  • Vana KD, Silva GE, Goldberg R. Predictive abilities of the STOP-bang and Epworth sleepiness scale in identifying sleep clinic patients at high risk for obstructive sleep apnea. Res Nurs Health. 2013;36:84–94.

    Article  PubMed  Google Scholar 

  • Varghese D, Datta S, Varghese A. Use of buccal myomucosal flap for palatal lengthening in cleft palate patient: experience of 20 cases. Contemp Clin Dent. 2015;6:S36–40.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wermker K, Lünenbürger H, Joos U, Kleinheinz J, Jung S. Results of speech improvement following simultaneous push-back together with velopharyngeal flap surgery in cleft palate patients. J Craniomaxillofac Surg. 2014;42:525–30.

    Article  PubMed  Google Scholar 

  • Yamaguchi K, Lonic D, Lee CH, Wang SH, Yun C, Lo LJ. A treatment protocol for velopharyngeal insufficiency and the outcome. Plast Reconstr Surg. 2016;138:290e–9e.

    Article  CAS  PubMed  Google Scholar 

  • Yang Z, Liu L, Fan J, Chen W, Fu S, Yin Z. Use of the buccinator musculomucosal flap for bone coverage in primary cleft palate repair. Aesthet Plast Surg. 2013;37:1171–5.

    Article  Google Scholar 

  • Zhao Z, Li S, Yan Y, Li Y, Yang M, Mu L, Huang W, Liu Y, Zhai H, Jin J, Ma X. New buccinator myomucosal island flap: anatomic study and clinical application. Plast Reconstr Surg. 1999;104:55–64.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil

    Rafael Denadai M.D. & Cesar Augusto Raposo-Amaral M.D.

  2. Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, 13084-880, Brazil

    Cassio Eduardo Raposo-Amaral M.D., Ph.D.

  3. Universidade de São Paulo, São Paulo, Brazil

    Cassio Eduardo Raposo-Amaral M.D., Ph.D.

Authors
  1. Rafael Denadai M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cassio Eduardo Raposo-Amaral M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cesar Augusto Raposo-Amaral M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rafael Denadai M.D. .

Editor information

Editors and Affiliations

  1. University of São Paulo Medical School, São Paulo, São Paulo, Brazil

    Nivaldo Alonso

  2. SOBRAPAR Hospital, Campinas, São Paulo, Brazil

    Cassio Eduardo Raposo-Amaral

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Denadai, R., Raposo-Amaral, C.E., Raposo-Amaral, C.A. (2018). Buccinator Myomucosal Flap in Cleft Palate Repair: The SOBRAPAR Hospital Experience. In: Alonso, N., Raposo-Amaral, C. (eds) Cleft Lip and Palate Treatment. Springer, Cham. https://doi.org/10.1007/978-3-319-63290-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-63290-2_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63289-6

  • Online ISBN: 978-3-319-63290-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation