Evidence-Based Practices in Cleft Palate Surgery | Journal CME Article-Journal CME Article: Evidence-Based Practices in Cleft Palate Surgery v4 of 6

Video Transcription

We are now going to harvest left buccal fat flap. The purpose for this flap is to provide additional vascularized tissue that will be transposed  between the nasal and oral mucosa, anterior to the muscular closure. As you can see, we're spreading deep to the buccinator muscle, and as we spread, we will  identify the buccal fat. When the proper plane is identified, the buccal fat can be teased out from deep to the buccinator muscle.  We're starting with a suction, and we gradually lyse the adhesions around the buccal fat so it can be used and transposed to our advantage.  If we choose to harvest both side buccal fat flaps, as we have done in this case, we can bring them together, again, anterior to the muscular closure.  This will serve both to provide a vascularized padding between the nasal and oral mucosal layers to prevent any dead space, and it will serve to prevent muscle migration anteriorly,  which we have observed when the dead space is left unfilled.

Video Summary

The procedure involves harvesting the left buccal fat flap to provide extra vascularized tissue between the nasal and oral mucosa, enhancing the surgical area. By working beneath the buccinator muscle, the buccal fat is identified and carefully extracted. Utilizing suction, the adhesions are gradually lysed to free the fat for use. Harvesting flaps from both sides allows them to be joined anteriorly, providing padding to prevent dead space and stop muscle migration. This technique is crucial for maintaining proper positioning and function post-surgery.

Keywords

buccal fat flap

vascularized tissue

buccinator muscle

surgical technique

post-surgery function