The buccal artery is a branch of the maxillary artery arising in the infratemporal fossa and running forward with the buccal nerve along the surface of the buccinator muscle. It supplies the buccinator muscle, the buccal fat pad, and the mucosa of the cheek, and anastomoses with the facial artery. It is the dominant blood supply to the pedicled buccal fat pad flap used in oral cavity reconstruction.
The buccal artery is the pedicle for the buccal fat pad flap, which provides vascularised tissue for closure of palatal fistulas, oroantral communications, and small oral cavity defects. The fat pad is accessed through a vertical incision in the buccal mucosa posterior to the upper second molar, and the pedicle based on the buccal artery allows reliable transposition to the midpalate. The buccal artery is also at risk during lateral maxillary osteotomy cuts in Le Fort and sagittal split procedures.
The buccal fat pad pedicled on the buccal artery provides a reliable vascularised flap for closure of oroantral fistulae and palatal defects up to 3 cm, transposed through a rotation incision in the buccal mucosa with the fat pad reaching across the alveolus or palate without tension.
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