A Buccal Space Approach for Midface Free Flap Reconstruction

Area of Science:

• Surgical Anatomy
• Reconstructive Surgery
• Microsurgery

Background:

• Midface reconstruction often requires reliable vascular access.
• Traditional approaches may carry risks of facial nerve injury or necessitate vein grafts.
• Aesthetic outcomes are a significant consideration in facial reconstruction.

Purpose of the Study:

• To describe a novel transbuccal approach for accessing the facial artery and vein.
• To evaluate the predictability and safety of this intraoral technique for midface free flap repair.
• To highlight the advantages of this method, including minimized facial nerve risk and avoidance of vein grafts.

Main Methods:

• Detailed cadaver dissection to map the transbuccal surgical pathway.
• Anatomical illustration and step-by-step description of the surgical technique.
• Review of anatomical knowledge to refine the approach.

Main Results:

• The transbuccal approach provides predictable access to the facial artery and vein.
• This intraoral technique minimizes the risk of facial nerve dysfunction.
• The method facilitates free flap midface reconstruction using short pedicles and avoids vein grafts.

Conclusions:

• The transbuccal approach is a reliable and esthetically preferable technique for accessing facial vessels.
• This method offers a safe and effective alternative for microvascular midface free flap reconstruction.
• Enhanced anatomical understanding supports the step-by-step application of this surgical approach.