A new space of the face: The bucco-mandibular space.
The inferiorly based buccinator myomucosal island flap is a useful reconstructive option for medium-sized intraoral mucosal defects. The pedicle length of this flap has not yet been determined. Thirteen fresh cadavers (26 sides) with intact faces were studied. An inferiorly based buccinator myomucosal island flap was elevated. Various measurements were taken, including pedicle length, paddle area, and pedicle length after dissection of the facial artery through the submandibular salivary gland; the presence of the facial artery or vein in the pedicle and the number of perforators were also evaluated. The mean pedicle lengths in the right and left sides were 4.8±0.6cm and 4.9±0.6cm, respectively. The mean pedicle lengths after dissection of the facial artery through the submandibular salivary gland were 7.8±0.7cm (right side) and 7.7±0.6cm (left side). The pedicle contained only the facial artery in six sides. There were two to three perforator branches from the facial artery to the mucosal paddle. Paddle sizes of the flap were in the range of 2.2×2.1cm to 3.5×3cm. This flap is suitable for the reconstruction of the floor of the mouth and tongue. Pedicle length can be increased significantly by dissecting the facial artery through the submandibular salivary gland.