Comparison studies of different flaps for reconstruction of buccal defects.

Our purpose was to evaluate the feasibility of radial forearm free (RFF) flap, platysma myocutaneous (PM) flap, and anterolateral thigh (ALT) flap in buccal reconstruction. This study consisted of 56 patients who were categorized into 3 groups. The Student t test was used to analyze the variables. Patients in group platysma flap were significantly older, the dissection of platysma flap was easier, and the defect was significantly smaller than those in group radial forearm flap and group ALT flap. The reduction in the widths of mouth opening between group PM, group RFF, and group ALT were compared. However, the reduction of mouth-opening widths in group RFF and group ALT was significantly less than that in group PM. Platysma myocutaneous flap may be more suitable in patients with small to middle-size defect and poor status, although the flap cannot achieve a reliable result; anterolateral thigh flap and radial forearm flap can preserve the interincisal distance well even for large buccal defect, but it takes more time and skills in the operation.