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Davis SJ, Park C, Shipchandler IT, Abdulhak A, Vernon D, Lee HB, Mantravadi AV, Ting J, Shipchandler TZ. Buccal Fat Advancement-Transposition Flap for Reconstruction of Midface Volume Defects. Facial Plast Surg Aesthet Med 2024; 26:497-502. [PMID: 38597716 DOI: 10.1089/fpsam.2023.0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background: The buccal fat pad (BFP) has previously been utilized for repair of various defects of the head and neck. Objectives: We explore the utility of a pedicled buccal fat advancement-transposition (BFAT) flap in various forms of midface reconstruction through a variety of surgical approaches and characterize its volume and axial reach in human anatomic specimens. Methods: Ten adult full-head human anatomic specimens were dissected, and a single surgical case demonstrating the use of a BFAT flap is described. Results: Nasolabial, subciliary, and deep plane facelift incisions all provided access to the BFP for use as a BFAT flap. The mean volume of mobilizable fat contained within a BFAT flap accessible through external incision was 7.1 cm3. Once fully mobilized, the externalized BFAT flap had a mean axial reach of 6.9 cm without tension. We also present a case illustrating the successful use of a BFAT flap for volumization of a large midface defect secondary to Mohs micrographic surgical resection of a cutaneous malignancy. Discussion: The BFAT flap, which exhibited substantial volume and reach in this study, can be harvested through multiple dissection windows or pre-existing defects and be used to reconstruct a variety of midface defects.
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Affiliation(s)
- Seth J Davis
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, 94301
| | - Christopher Park
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Isaac T Shipchandler
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Abraham Abdulhak
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dominic Vernon
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Hui Bae Lee
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Avinash V Mantravadi
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jonathan Ting
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Taha Z Shipchandler
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Taguchi A, Yoshida T, Watanabe Y, Kusano J, Oe K, Okamura K, Tanaka C, Hiratsuka Y. Buccal fat pad flap for transoral repair of radiation-induced necrosis in the lateral oropharyngeal wall. Auris Nasus Larynx 2023:S0385-8146(22)00244-9. [PMID: 36621449 DOI: 10.1016/j.anl.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
Soft tissue necrosis (STN) is a late toxicity after radiotherapy. Extensive tissue defects due to STN near the carotid artery, such as in the lateral oropharyngeal wall, may lead to infectious pseudoaneurysms associated with fatal bleeding. Such defects are usually treated with transcervical reconstructive surgeries, which are highly invasive and technically difficult. We report a case in which a buccal fat pad (BFP) flap was used for minimally invasive transoral repair of tissue defects due to radiation-induced STN in the lateral oropharyngeal wall. The BFP flap covered the tissue defect, and the wound epithelialized completely. The patient had no dysfunctional mouth opening, speech, or swallowing. The BFP flap can be easily harvested via a minimally invasive transoral approach and is expected to be further utilized for radiation-induced STN in the lateral oropharyngeal wall.
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Affiliation(s)
- Atsushi Taguchi
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takao Yoshida
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan.
| | - Yoshiki Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Junko Kusano
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Kengo Oe
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Kana Okamura
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Chisato Tanaka
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Yasuyuki Hiratsuka
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
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