Cleft Palate Repair Surgical Complications Following Buccinator Myomucosal Flap Surgery

The buccinator musculomucosal flap was found to be a useful alternative for palatal fistula and velopharyngeal insufficiency repair. This surgical technique has become increasingly common in the surgical management of secondary cleft palate deformities during the last years; however, few studies have been published documenting associated postoperative complications.The present study was carried out to present a case series and describe observed surgical complications associated with this technique used by the authors.

This is a retrospective outcome study of patients with sequels after primary cleft palate repair (palatal fistulas, flap necrosis, or velopharyngeal insufficiency) admitted to our center and operated by a single surgeon using the buccinator flap from 2017 to July 2024.A review of the literature for studies published until November 2024 was performed to evaluate postoperative complications after using this technique.

A total of 42 cleft palate patients with postoperative sequels have been operated using the buccinator musculomucosal flap by a single surgeon (P.R.P.) from 2017 to 2024.The most common cleft palate sequel after primary cleft palate repair in this series was the mucoperiosteal flap necrosis 10/42 (23.8%), velopharyngeal insufficiency 21/42 (50%) and palatal fistula 11/42 (26.19%).The most common complications after buccal myomucosal flap surgery were flap dehiscence and partial flap necrosis in 13 (30.95%) and 8 (19.04%) of patients, respectively.

Buccinator (buccal) flap is an alternative for reconstruction of cleft palate sequels; however, their potential complications are not rare and should be prevented.