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The purpose of this study was to examine the biological properties of the buccal fat pad (BFP)-derived tissue stromal vascular fraction (tSVF) in vitro and compare them with BFP-derived cellular SVF (cSVF). Furthermore, a clinical pilot study assessed the safety of using BFP-derived tSVF for maxillofacial bone regeneration. This study was performed in two sections: 1) experimental section: BFP tissue was harvested from three healthy donors, and then cSVF and tSVF were isolated by enzymatic and mechanical methods to assess their biological properties and 2) clinical section: Ten patients with maxillofacial bone defects were enrolled according to eligibility criteria and offered two options for surgery, including autologous BFP-tSVF (n = 5) and autologous bone grafting (n = 5), to evaluate safety after a year of follow-up. The BFP-tSVF exhibited high cell viability and various cell surface markers, including CD45, CD31, and CD34. There was no population-doubling time and multilineage differentiation capacity compared with BFP-cSVF. BFP-tSVF is safe because of the lack of intervention-related adverse events reported in donor and surgery sites during a one-year period. In addition, cell therapy was feasible because it can be performed during surgery and requires little preparation time. Patients in the ABG group experienced pain and tenderness in the iliac crest, leading to dissatisfaction and complications. The experimental results confirmed that the cells isolated from BFP-tSVF have stemness properties similar to BFP-cSVF. Clinical evaluation also indicated that this cellular product could be used safely to regenerate maxillofacial bone defects. [ABSTRACT FROM AUTHOR]

There are many reconstruction techniques for the repair of the intraoral buccal defects following oncological resections. The pedicled buccal fat pad (BFP) flap can be used for reconstruction of medium-sized buccal defects. The purpose of this study was to investigate the outcomes of the reconstruction with BFP flap following the resection of buccal tumors and risk factors on BFP flap success. This study was designed as a retrospective case series research. Ten patients with squamous cell carcinoma of the buccal mucosa underwent BFP flap reconstruction following tumor resection. The dimensions of the primary tumor and post-resection defect were calculated. The intraoral operation field was evaluated on the postoperative 7th day and in the postoperative 1 st and 6th months. Postoperative flap status, disease recurrence, risk factors for flap success were assessed. The mean greatest dimension of the post-resection buccal defect was 41.9 ± 10.3 mm. A partial dehiscence was observed in three patients in the postoperative 7th day. The 6th month-examination revealed no flap complications. The mean greatest dimension of post-resection buccal defect in uncomplicated patients was 42.7 ± 11.4 mm and in patients with partial dehiscence was 40 ± 8.6 mm (p = 0.727). There was no significant difference between uncomplicated patients and patients with partial dehiscence according to body mass index (normal vs overweight, p = 0.667). The BFP flap is a reliable reconstruction method in medium sized buccal defects following oncological resection. It has low complication and donor site morbidity rates and also good anatomical and oncological outcomes. [ABSTRACT FROM AUTHOR]

Tumours of salivary glands are rare and have various histo-pathological subtypes. Myoepitheliomas were first classified by Sheldon et al. and the criterion to classify or diagnose it was first defined by Barnes et al. and Sciubba and Brannon. Myoepithelioma accounts for less than 1 % of all salivary gland tumours, 40 % of these tumours occur in the parotid gland while 21 % occur in the minor salivary glands. A case of myoepithelioma of a minor salivary gland of the cheek is described, emphasizing the problems of the differential diagnosis. A 40-year-old female reported to the department with a complaint of a cheek bite on her right side for a few months. The physical examination showed a presence of lobulated whitish mucosa on the right buccal mucosa at the level of the occlusal plane, on palpation it revealed a non-painful mass approximately 1.5 cm in radius, mobile to bimanual palpation. An excisional biopsy was performed under local anaesthesia. Microscopic and immunohistochemistry confirmed the tumour to be a myoepithelioma of a minor salivary gland with the absence of definitive features of malignancy. Due to their infrequency and multiplicity of histopathology, myoepitheliomas present difficulties in diagnosis. Cellular varieties can be misdiagnosed as malignancies. A key to determining diagnostic criteria for myoepitheliomas is to study cellular morphology, cytoplasmic filament expression, and ultrastructural features of the tumour and apply this information to defining myoepitheliomas. Myoepitheliomas are rare tumours, utilization of immunohistochemical staining and electron microscopy are useful tools for the diagnosis of myoepitheliomas to ensure proper treatment and follow-up. • Myoepithelioma of minor salivary gland • Buccal fat pad reconstruction • Electron microscopy and Immunohistochemistry • Benign salivary gland pathology [ABSTRACT FROM AUTHOR]

This technical note documents an easily reproducible technique to improve velar competency after transoral lateral oropharyngectomy extending to the velum. [ABSTRACT FROM AUTHOR]

Human amniotic membranes (HAMs), as a biological membrane with healing, osteogenic, and cell therapy potential, has been in the spotlight to enhance the outcomes of treating bone defects. Present study aims to clinically assess the potential of HAM loaded with buccal fat pad-derived stem cells (BFSCs) as an osteogenic coverage for onlay bone grafts to maxillomandibular bone defects. Nine patients with jaw bone defects were enrolled in the present study. The patients were allocated to two study groups: Iliac crest bone graft with HAM coverage (n = 5), and Iliac bone grafts covered with HAM loaded with BFSCs (n = 4). Five months following the grafting and prior to implant placement, cone beam computed tomography was performed for radiomorphometric analysis. The mean increase in bone width was found to be significantly greater in the HAM + BFSCs group (4.42 ± 1.03 mm versus 3.07 ± 0.73 mm, p < 0.05). Further, the changes in vertical dimension were greater in the HAM + BFSCs group (4.66 ± 1.06 mm versus 4.14 ± 1.03 mm, p > 0.05). Combined use of HAM with mesenchymal stem cells may enhance bone regeneration specifically in the horizontal dimension. Moreover, this methodology reduces the amount of harvested autogenous bone and diminish secondary bone resorption. [ABSTRACT FROM AUTHOR]

‘Krokodil’ is the street name of a new synthetic drug mixture. It is a light brown liquid that is used intravenously without previous purification. Osteonecrosis of the jaw (ONJ) is a common complication among Krokodil users. Krokodil drug-related ONJ presents as alveolar process exposure in the oral cavity. Surgery is the main method for treatment of Krokodil drug-related ONJ patients. In a study by Poghosyan et al., no cases of recurrence were seen after surgery on the maxilla, but 38% of cases (8/21) developed an oroantral communication after surgical treatment for maxillary osteonecrosis (Poghosyan et al., 2014). The aim of this study is to report on the results of buccal fat pad use in closure of maxillary sinus floor defects after partial maxillary resection in Krokodil drug-related ONJ patients. Six male patients with Krokodil drug-related distal maxillary osteonecrosis were included in this retrospective study. All patients underwent surgical treatment, which included surgical removal of necrotic bone, and closure of formed maxillary sinus floor defects with buccal fat pad and local mucoperiosteal flaps. In all patients the postoperative period was uneventful. After suture removal small areas of buccal fad pad exposure were found in all patients, which epithelialized successfully over the following month. During the postoperative follow-up period (8–12 months) no signs of recurrence were found. [ABSTRACT FROM AUTHOR]

Abstract Traumatic herniation of buccal fat pad (BFP) is very rare, usually seen in young children, from 5 months to 12 years of age. A minor injury or perforation of the buccinator muscle and buccal mucosa can cause the extrusion of the buccal fat pad into the oral cavity. A differential diagnosis is very important but a history of trauma, an absence of masses before the accident, anatomical site and fatty appearance should suggest the correct diagnosis. The treatment options are usually excision or repositioning of the herniated fat. For the present case report, a 7 month-old boy, diagnosed with traumatic buccal fat pad herniation, was successfully treated with surgical excision. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse preoperatively with ultrasound the minimum volume of buccal fat that would be required for interposition of a pad after gap arthroplasty, and to emphasise the value of such a pad in the management of ankylosis of the temporomandibular joint (TMJ) during a short term follow up. Nineteen patients with ankylosis of the TMJ (22 joints) were selected, whose mean (SD) mouth opening was 4.9 (3.7) mm. In 10 joints in which the mean (SD) volume of the buccal fat pad was 0.7 (0.2) ml, the harvested buccal fat was inadequate for interposition, so they were treated with other materials. The remaining 12 joints had a mean (SD) volume of 1.1 (0.3) ml, which gave enough fat for interposition after gap arthroplasty. Investigation with ultrasound at 15 days and 6 months postoperatively showed that the fat pad was viable and the volume had shrunk by 28%. The 6-month postoperative computed tomographic (CT) scan showed little or no heterotopic calcification. We conclude that a buccal fat pad with a preoperative mean (SD) volume of 1.1 (0.3) ml is easy to harvest as interposition material. At a mean follow up of the12 joints after 31 (range 24 - 36) months there was progressive improvement in mouth opening with a mean (SD) of 32.5 (5.0) mm, which established that a pedicled buccal fat pad is a stable, efficient, viable soft tissue barrier in the management of ankylosis of the TMJ. [ABSTRACT FROM AUTHOR]

Objectives The objectives of this study were to evaluate the effectiveness of pedicled buccal fat pad in the surgical management of oral submucous fibrosis and assessment of interincisional opening, relief from symptoms, wound healing and relapse rate. Study design A total of 20 patients of oral submucous fibrosis of group IVa (Khanna and Andrade) were selected for the study. Patients were strongly advised for discontinuation of any adverse oral habits. Patients were followed up for one year. Results Mean preoperative mouth opening was 11.25mm (SD 3.46mm) and intraoperative mean mouth opening achieved was 41.75mm (SD, 3.74mm). Mean postoperative mouth opening after 1 year follow up was of 31.05mm (SD 6.80mm). None of the cases showed infection at any postoperative time interval. A total of 2 (10%) patients reported of burning sensation and a total of 1 (5%) had wound dehiscence which was subsequently managed successfully. A total of 2 (10%) patients showed relapse. Overall success rate was 90%. Conclusion Buccal fat pad functions well as a pedicled graft in the surgical management of oral submucous fibrosis. The healing was uneventful with the uptake of graft but vigorous postoperative physiotherapy was necessary for the first three months and continuing it for a minimum for 1 year to maintain the postoperative mouth opening achieved intraoperatively. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Supracricoid laryngectomy with Cricohyoidoepiglottopexy (SCL-CHEP) is a functional organ preservation surgery for laryngeal cancers. Post-operative laryngeal function is generally promising. Some patients, however, cannot attain satisfactory functional results because of an excessively wide neoglottis resulting in an insufficient neoglottal closure. Autologous buccal fat augmentation was conducted to correct the insufficiency. Patients and Methods: Two patients underwent intervention. Under general anesthesia, autologous fat was harvested from the buccal fat pad. Fat tissue was injected into the widest plane of the neoglottis under direct laryngoscopy; a navigation system was incorporated to identify the responsible site. Acoustic, aerodynamic, and perceptual analyses along with videofluoroscopic swallowing study and screening questionnaires were used for functional evaluation. Results: A total of 0.8ml (Case 1) and 0.7ml (Case 2) of fat tissues were injected into the submucosal space of the responsible sites. Both patients experienced functional improvement subjectively after augmentation; psychological parameters for voice and swallowing also improved. Conclusions: Buccal fat augmentation to correct insufficient neoglottal closure after SCL-CHEP was technically feasible. A navigation system was helpful for confirmation. Fat absorption occurred and one third of the volume remained at 3 and 6 months. Although, vocal measurements remained unchanged, psychological parameters for voice and swallowing improved. [Copyright &y& Elsevier]

Abstract: The use of buccal fat pad in the management of osteoradionecrosis has not been described previously. A series of 10 consecutive cases of osteoradionecrosis treated with a combination of sequestrectomy and buccal fat pad is presented. The data were obtained by reviewing operative and medical records. The combination of sequestrectomy and buccal fat pad flap was successful in 86% of cases of stage II osteoradionecrosis and in 0% of cases of stage III. The overall success rate was 60%. Based on the result of this series, this treatment regime appeared to be beneficial in stage II osteoradionecrosis. [Copyright &y& Elsevier]

Abstract: This study evaluated the long term effectiveness of pedicled buccal fat pad (BFP) with or without buccal advancement flap in the closure of oroantral fistula (OAF). A prospective clinical study involving 15 patients with chronic OAF was carried out. All cases were managed with pedicled BFP as the primary or secondary procedure. Cases with doubtful outcome were closed in two layers using BFP along with buccal advancement flap. Cases were followed for 3 months (1, 4, 8 and 12 weeks) to evaluate any postoperative complications such as wound dehiscence, necrosis or infection. Females (66.7%) in their third to fourth decade were commonly affected in the right posterior region (75%). Dental extraction (73.3%) followed by maxillofacial pathology was the most common causes for developing OAF. Only 2 of 15 cases were closed in two layers. Complete epithelialisation of all the cases was observed with no postoperative complications. Pedicled BFP is an effective and reliable flap for the repair of OAF. Cases of larger oral defects with doubtful outcome can be closed in two layers using BFP along with buccal advancement flap. [Copyright &y& Elsevier]

Abstract: Introduction: Oral submucous fibrosis (OSMF), a chronic debilitating condition of the mouth, has been treated both surgically and non-surgically, but non-surgical methods yield inconsistent results. The surgical methods essentially comprise of bilateral sectioning of fibrous bands with or without coronoidectomy followed by covering of the surgical defect with a graft or a wound dressing material such as collagen sheet. Materials and Methods: This study comprised 30 clinically diagnosed cases of OSMF. This study compared transposition of buccal pad fat graft with collagen sheet to cover the defect within the following parameters: pain, swelling, mouth opening, color of mucosa, palpability of fibrous bands, and suppleness of mucosa. Results: We found significant difference in the postoperative mouth opening, an insignificant difference for post surgical morbidity and higher grades of surgical convenience in using collagen sheet as a wound dressing material. Conclusion: Collagen membrane is a superior method compared to transposition of the buccal pad of fat as a graft to cover the surgical wound in the treatment of OSMF of grade III and above. [Copyright &y& Elsevier]

Abstract: The buccal fat pad (BFP) as pedicled graft was originally used in reconstructing medium sized intraoral defects. Promising results concerning the use of BFP in cleft palate surgery have been published recently. The aim of this article is to report on the use of BFP as a pedicled graft in cleft palate surgery and to discuss promising results for this reconstructive surgical concept. A retrospective evaluation of 24 patients who had BFP pedicled flaps used for the prevention and repair of Type III (Pittsburgh Fistula Classification) cleft palate fistulas, to obstruct the retromolar space of Ernst and in case of wide clefts, from 2005 to 2010, was conducted. In all cleft palate patients, the recipient area fully epithelialized within 4 weeks or less. No recurrence was seen and the donor site healed well without aesthetic or significant functional impairment. This series confirms the excellent and predictable healing of BFP intraorally and the minimal morbidity associated with the use of such grafts. The results of this study allow the authors to recommend that the BFP pedicled flap is considered as a reliable alternative procedure to expand the therapeutic options. The BFP graft provides an advantage in reconstructive cleft palate surgery. [Copyright &y& Elsevier]

Summary: Postoperative head and neck cancer patients suffer from speech disorders, which are the result of changes in their vocal tracts. Making a solid vocal tract model and measuring its transmission characteristics will provide one of the most useful tools to resolve the problem. In binary conversion of X-ray computed tomographic (CT) images for vocal tract reconstruction, nonobjective methods have been used by many researchers. We hypothesized that a standardized vocal tract model could be reconstructed by adopting the Hounsfield number of fat tissue as a criterion for thresholding of binary conversion, because its Hounsfield number is the nearest to air in the human body. The purpose of this study was to establish a new standardized method for binary conversion in reconstructing three-dimensional (3-D) vocal tract models. CT images for postoperative diagnosis were secondarily obtained from a CT scanner. Each patient''s minimum settings of Hounsfield number for the buccal fat-pad regions were measured. Thresholds were set every 50 Hounsfield units (HU) from the bottom line of the buccal fat-pad region to −1024HU, the images were converted into binary values, and were evaluated according to the three-grade system based on anatomically defined criteria. The optimal threshold between tissue and air was determined by nonlinear multiple regression analyses. Each patient''s minimum settings of the buccal fat-pad regions were obtained. The optimal threshold was determined to be −165HU from each patient''s minimum settings of the Hounsfield number for the buccal fat-pad regions. To conclude, a method of 3-D standardized vocal tract modeling was established. [Copyright &y& Elsevier]

Summary: Lipoaugmentation is a treatment option for patients suffering from glottic insufficiency. Autologous fat is a nearly ideal material for vocal-fold augmentation from the view of biocompatibility and viscoelasticity, but there is still the problem of high graft resorption. As distribution and biological behavior of fatty tissue is very different in the human body, the aim of the study was to elucidate possible donor sites with respect to the quantity of harvested fat, the surgical accessibility to the region, the donor site morbidity and possibility of aesthetic defects and the quality of harvested tissue. Possible donor sites for harvesting were examined by magnetic resonance imaging in thirty-five patients with special emphasis to the buccal fat pad, the neck, the dorsolateral side of the proximal upper extremity, the subcutaneous layer of the abdominal wall, the superficial trochanteric region, the medial thigh, and the infrapatellar fat pad. Identified regions that failed to be chosen into consideration because of an elaborate surgical approach (superficial axillary''s space, ischio-anal fossa, subcutaneous layer of buttock, popliteal fossa) were not taken into consideration. The mean volume of the buccal fat was 3.994 cm3; the average thickness of the fat at the level of C7 was 1.721 cm, the mean value in the upper extremities was 1.913 cm laterally and 1.275 cm dorsally. The subcutaneous fat of the abdominal wall was divided into a superficial compartment (mean: 1.527 cm) and a deep one (average: 3.545 cm). In the superficial trochanteric region, the mean thickness was 2.536 cm, in the medial thigh 2.127 cm; the mean volume of the infrapatellar fat pad was 20.198 cm3. All regions of interest showed reproducible and sufficient amounts of harvestable tissue, we found significant intersexual differences in dorsolateral side of the upper arm, subcutaneous layer of the abdominal wall and superficial trochanteric region. When harvesting subcutaneous tissue of the abdominal wall, grafts of the deep layer should be preferred, in the upper extremity the deep, muscle-neighbored parts. An alternative method is the surgically accessible fat of the neck. Solid fat pads could be harvested from the buccal region or the infrapatellar fat. [Copyright &y& Elsevier]

Summary: Reconstruction of cheek mucosa defects following tumor resections can be approached with several techniques, depending on size of the defect. Fasciocutaneous and perforators free flaps are widely employed today for such reconstructions. However, small defects or general health of the patient may limit their indications. Furthermore, approaching moderate size defects, some techniques, like temporalis muscle or fascia pedicled flaps, lead to contracture with limitation of mouth opening or trisma, and others, like intraoral local flaps, do not provide enough tissue for the reconstructions. In this work the authors propose, for reconstructing these kind of defects, the use of a buccinator myomucosal island flap and a buccal fat pad pedicled flap association. A case is reported and the surgical technique is explained. This new reconstructive technique can easily be used for reconstructing moderate-sized cheek defects, achieving optimal results: the internal mucosal lining is restored in few weeks without any retraction, contracture, of scars on the face limiting the aesthetic outcome and mouth opening. [Copyright &y& Elsevier]

Summary: The buccal fat pad (BFP) has been the subject of numerous publications regarding its anatomy and clinical implications, however our interest in the pathology was aroused by two cases of lipoma originating from the BFP that were particularly interesting as one lipoma was congenital and the other recurred. A search of the international literature revealed a further 27 cases of BFP lipoma dating from 1848 to 2002. This suggests it is a rare entity but the authors suspect it to be under reported because of unfamiliarity with the possibility and the various atypical characteristics that were observed. Firstly, BFP lipomas appear to be congenital relatively often. Also, many are histological variants such as the spindle-cell lipoma, which could be associated with a more diffuse growth in the various extensions. As the deep extensions are not routinely removed due to the difficulty of the procedure, this could result in incomplete resection and recurrence. A possible explanation is the hypothesis that the BFP has a different embryological origin than subcutaneous fat. More importantly, well-differentiated liposarcoma of the BFP has also been described, which may be clinically and histologically indistinguishable from spindle-cell lipoma. Therefore, the authors recommend a careful workup of every mass of the buccal space with consideration of the BFP as a possible origin. Detailed knowledge of the anatomy and extensive MR-imaging are paramount in guiding the surgical approach by visualising the extent of growth in the various extensions, and determining if the radiological picture is suggestive of liposarcoma. [Copyright &y& Elsevier]

Abstract: The aim of this study was to evaluate the use of pedicled buccal fat pad flap (PBFPF), prefabricated titanium mesh and autologous bone graft in maxillary reconstruction. Seventeen patients with a unilateral class I–III maxillary defect were involved. Preoperatively, a solid model was manufactured based on virtual maxillectomy and reconstruction of the abnormal maxilla. Intraoperatively, PBFPF was applied to repair the soft-tissue defect, serving as nasal lining and the receiving bed for bone grafts. Titanium mesh was prefabricated on the solid model and then, together with bone grafts from iliac crest, fixed to residual bones to reconstruct the hard-tissue defect. Postoperative aesthetic appearance and function were followed up. No exposure of titanium mesh, leakage or oronasal regurgitation occurred. Of the patients with a class I or II defect 91% (10/11) and of those with a class III defect 50% (3/6) gained a good appearance. Fifteen patients were articulate. Eleven patients received dental rehabilitation and had a normal diet. PBFPF with prefabricated titanium mesh and autologous bone grafts is a reliable option for reconstruction of unilateral maxillary defects of class I and II, but this method alone should be used cautiously in defects of class III and beyond. [Copyright &y& Elsevier]

Novel technologies for management and reconstruction of complex bony defects regarding both function and facial appearance are interestingly used in maxillofacial surgery. In the current study, we demonstrated reconstruction of a bilateral ramus-condyle unit (RCU) defect while preserving both condyles by a novel designed titanium prosthesis using virtual surgical planning (VSP), computer-aided design and manufacturing (CAD/CAM), and Selective Laser Melting (SLM) technologies. A 3D customized titanium prosthesis was designed for a 49 -year-old patient with bilateral mandibular aggressive central giant cell granuloma (CGCG) according to mandibular normal anatomy and structure while preserving bilateral intact condyles. Finite element study was performed to investigate the effects of new design strength and the stress shielding phenomenon. The design of macro-pores inside the body of prosthesis allowed it to act as a scaffold for bone tissue engineering under load bearing conditions. Analysis of the strength and stress shielding phenomenon demonstrated favorable outcomes regarding the novel design. For instance, there was no stress shielding in any of the preserved condyles with regard to the size and distribution of stresses. Also, the stress distribution around the pores showed that these pores had no effect on the strength of the prosthesis. Thirty month follow-ups after reconstruction of bilateral RCU defect showed normal jaw function with a favorable facial appearance and mandibular contour. We design a novel patient-specific prosthesis with desirable biomechanical features for reconstruction of bilateral RCU defect after resection of the benign tumor with preservation of bilateral intact condyles. [ABSTRACT FROM AUTHOR]

Abstract: Traumatic pseudolipoma is a term used to describe intra-oral herniation of the buccal fat pad. A tear of the buccinator muscle and buccal mucosa allows the buccal fat pad to extrude into the oral cavity. Initially, the lesion can suggest a more sinister cause, but a history of trauma, an absence of mass before the accident, anatomical site and fatty appearance should suggest a diagnosis of traumatic herniation of buccal fat pad. This injury is rare, but two cases presented to the authors’ hospital over a period of 3 months. [Copyright &y& Elsevier]

Abstract: We have used the pedicled buccal fat pad in a patient with a wide unilateral cleft palate when there was tension in the nasal layer even after complete release. The levator muscle was dissected and repositioned and the nasal layer was released transversely at the site of maximum tension between the hard and soft palate. The pedicled flap was placed into this defect. Pedicled buccal fat pad can be brought from the lateral releasing incision itself without adding another donor site. The postoperative course was uneventful. [Copyright &y& Elsevier]

Background: Buccal mucosa defects following resection of premalignant or malignant lesions require adequate reconstruction. Both locoregional and microvascular flaps have been extensively used based on operator and patient factors. This paper focuses on the outcomes of a simplified approach for reconstruction of large buccal mucosa defects with posterior extent using a combination of two loco regional flaps.Method: A combination of buccal fat pad graft and nasolabial flap was used to reconstruct large defects spanning the buccal mucosa extending to the soft palate or retromolar trigone areas. Post operative outcomes were noted in patients who underwent reconstruction using this combination technique.Result: This paper highlights the favourable results and ease of technique with this combination of flaps, i.e complete coverage of large buccal mucosa defects extending to critical areas such as soft palate, retromolar trigone or tonsillar pillars; avoiding sophisticated free flaps. Satisfactory healing with adequate functional and esthetic outcomes were seen.Conclusion: Defects post ablation of buccal mucosa lesions, larger than 5 cm × 5 cm, can be reconstructed using double local flaps. Buccal fat pad and nasolabial flaps heal excellently with nil morbidities and their combination provides a simple and an economical alternative option for reconstructive surgeons. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to consider the anatomical basis and surgical technique along with the utility of buccal fat pad (BFP) for the reconstruction in cleft lip and palate patients. We reviewed 27 cases of CLAP treated with BFP over three year period in our institution which included 2 cases of primary palatoplasty & 25 cases of secondary palatoplasty. Inclusion criteria consisted of patients operated by a single surgeon with a minimum follow up of 2yrs. Exclusion criteria included all syndromic cleft lip and palate patients. Predictor variables recorded were demographic characters, follow up period, type of cleft, type of surgical procedure, site & dimension of the fistula. Outcome variables of the study were post-operative fistula formation, post-operative hemorrhage & speech assessment. The study included 8 female & 19 male patients with mean age group 3.75 ± 1.75yrs. Cleft of soft palate & Lt. CLAP were the most common type of cleft. The surgical technique used was: BFP with V–Y pushback palatoplasty for primary palate repair, BFP with Furlow's technique for VPI correction, and BFP in conjugation with rotation flap, straight-line closure or redohardpalatoplasty for fistula closure. All cases showed satisfactory healing with favorable speech assessment outcomes for 18 patients (67%). BFP along with other types of flap is the choice of treatment in cases of moderate defect owing to its favorable anatomic location & high vascularity. The size limitation of the BFP must be known to permit a successful outcome. [ABSTRACT FROM AUTHOR]

The anatomy of the inferior orbital fissure has been well studied, and its reported dimensions vary little. It is encountered during exploration of the orbital floor and when possible is not disturbed. We describe a case of herniation of buccal fat through the inferior orbital fissure that was found during exploration and repair of the orbital floor. [ABSTRACT FROM AUTHOR]

Abstract: We herein report a case of traumatic herniation of the buccal fat pad. A 2-year-old female patient presented with a chief complaint of mass formation in the buccal mucosa after trauma by a toothbrush. An elastic-soft mass approximately 20mm×20mm in size was located in the left buccal mucosa. The clinical diagnosis was herniation of the buccal fat pad. The lesion was excised under local anaesthesia. Histopathologic examination revealed adipose tissue with ulceration of the overlying epithelium, inflammatory cell infiltration, and formation of granulation tissue. The final pathological diagnosis was pseudolipoma at the buccal mucosa. There has been no recurrence for 3 months. [Copyright &y& Elsevier]

Abstract: Purpose: The aim this study was to compare the buccal fat pad (BFP) and nasolabial flap for reconstruction of intraoral defects after release of fibrous bands in patients with oral submucous fibrosis (OSF). Materials and methods: This is a comparative study. The study sample was derived from the population of patients who presented, with restricted mouth opening of less than 20 mm, to the Department of Oral and Maxillofacial Surgery, Swargiya Dada Saheb Kalmegh Dental College and Hospital Hingna Nagpur. The patients were divided into two groups. In Group I (n = 10) reconstruction was performed with a nasolabial flap and in Group II (n = 10) with BFP. Both groups were analysed separately for mouth opening (interincisal distance in millimetres) preoperatively and 20 months postoperatively, time taken for epithelialization of BFP and nasolabial flaps. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Inc, Chicago, IL) using the _2 test and Student's t test. Results: In all 20 patients the interincisal mouth opening was (mean) 11 mm (3–19 mm) preoperatively which improved to a mean of 42 mm (23–52 mm). In Group I there were more complications as compared to Group II such as partial flap necrosis particularly at the tips, temporary widening of oral commissure and subluxation of TMJ. The unsightly extraoral scar and intraoral growth of hairs were not seen in Group II. Conclusion: BFP is the better choice for reconstruction in comparison to nasolabial flap. [Copyright &y& Elsevier]