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

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).