Cheek mucosa : a versatile donor site of myomucosal flaps. Technical and functional considerations

Background: Reconstruction of moderate-sized mucosal defects of the oral cavity/oropharynx represents a surgical challenge. The most widely used reconstructive techniques are skin grafts, local or regional pedicled flaps, and free flaps, but they do not provide mucosal sensitivity, mobility, volume, or texture similar to that of native tissue. The cheek myomucosal flaps seem to provide "ideal reconstruction" because they carry a thin, mobile, well-vascularized, and sensitive tissue, like those excised or lost. The purpose of this retrospective analysis was to evaluate the indications for the advantages and disadvantages of 6 types of buccinator myomucosal flaps which are possible to raise from the cheek mucosa. Methods: Sixty-nine buccinator myomucosal flaps were performed on 66 patients with moderate-sized postoncologic and posttraumatic oral and oropharyngeal defects. Results: In all cases except 1, flaps were successfully used with excellent oncological and functional results. Conclusion: Buccinator myomucosal flaps can be considered "ideal flaps" for three-dimensional oral and oropharyngeal reconstructions