Author(s)
Jared Garfinkle, BS
Gabrianna Andrews
Julia Rangel
Wen Luo
Meredith Lehoe
Stephen Nogan
Affiliation(s)
Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ: Andrews, Rangel, Luo
OhioHealth Otolaryngology Department at Doctors Hospital, Columbus, OH: Lehoe, Nogan
Columbus Facial Plastics, Columbus, OH: Nogan
Abstract:
Background: Buccal fat pad (BFP) grafting has been shown as a promising alternative for reconstructing the oropharyngeal cavity following tumor excision
Learning Objectives: Describe the indications, advantages, and complication profile of the BFP flap.
Study Objective: Evaluate complication rates, graft success, and related factors surrounding the use of BFP for reconstruction in head and neck surgery.
Design Type: Systematic review and Meta-analysis
Method: A systematic search was conducted across 4 databases. Included studies were available in full-text English.
Results: 113 patients (mean age = 60.8±8.69) underwent primary reconstruction of head and neck neoplasms using a pedicled BFP flap alone, or with adjuvant flaps. 72.6% were diagnosed with squamous cell carcinoma and 8.8% with verrucous carcinoma. Defect locations included the buccal mucosa (n=50), mandible/mandibular gingiva (n=6), maxilla/maxillary gingiva (n=36), palate (n=6), posterior oral cavity (n=11), oral floor (n=1), and other oral cavity locations. Defect size ranged from 0.71-6.55cm (mean 2.95±1.07). 27 patients (23.9%) experienced postoperative complications, with partial dehiscence occurring in 18.2% (95% CI, 7.3%-38.5%) of cases. Statistical analyses revealed no significant associations between complication type or defect size; chi-square testing showed no association between defect size and fistula formation (2=0.26, p=0.608) or dehiscence (2 = 0.04, p=0.844).
Conclusion: The BFP flap offers a reliable and low-morbidity reconstructive option for minor oral and oropharyngeal defects following tumor excision.