Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid

Echlin, K; Whitehouse, H; Schwaiger, M; Nicholas, R; Fallico, N; Atherton, DD.
"A cadaveric study of the buccal fat pad: implications for closure of palatal fistulae and donor site morbidity."
Plast Reconstr Surg. 2020;
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Autor/innen der Med Uni Graz:
Schwaiger Michael
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Abstract:
For the cleft surgeon, palatal fistulae after cleft palate repair remain a difficult problem with a paucity of local tissue options to aid closure. Small clinical series have described the use of the buccal fat pad flap (BFPF) to repair palatal fistulae; however, there is no literature detailing the anatomical coverage of the flap. This study delineates the anatomy of the BFPF to guide surgeons in patient selection and examines the residual buccal fat after flap harvest to provide new information as to possible effects on the donor site. BFPFs were raised in 30 hemi-cadavers. The reach of the flap across the midline, anteriorly and posteriorly was recorded. In 18 hemi-cadavers the entire BFP was then exposed to determine the effects of flap harvest on movement and volume of the residual fat. All BFPFs provided coverage from the soft palate to the posterior 1/3 of the hard palate and all cross the midline. Approximately ¾ flaps would cover the mid-hard palate. The flap comprises 36% of the total BFP on average and a series of retaining ligaments was identified that may prevent over-resection. The BFPF is a useful tool for coverage of fistulae in the soft palate to the posterior 1/3 of the hard palate. In most cases it will also reach the middle 1/3, however, it is not suitable for more anterior defects. On average 2/3 of the BFP remains within the cheek after flap harvest which may protect against unwanted alteration in aesthetics.

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