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      Traumatic herniation of buccal fat pad into the oral cavity in an infant: A case report

      case-report

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          Abstract

          Buccal fat herniation is a rare traumatic disease that should be included in differential diagnosis of infants' oral cavity mass. History of proceeding trauma, careful evaluation of mucosal perforation aiding the diagnosis.

          Abstract

          Buccal fat herniation is a rare traumatic disease that should be included in differential diagnosis of infants' oral cavity mass. History of proceeding trauma, careful evaluation of mucosal perforation aiding the diagnosis.

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          Most cited references11

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          Lipomas of the oral cavity: clinical findings, histological classification and proliferative activity of 46 cases.

          Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. Although relatively common, few large series of intraoral lipomas and its variants are seen in the literature. Therefore, the authors present the clinical, histological and immunohistochemical features of 46 cases of intraoral lipomas reviewed from the files of the University of Campinas Dental School from 1970 to 2001. Most of the cases affected adults, without gender predilection, and the main involved sites were the buccal mucosa (21 cases), tongue (six cases), lips (six cases) and floor of mouth (five cases). The histological analysis revealed 21 cases of lipoma, 18 fibrolipomas, four intramuscular lipomas, two minor salivary gland lipomas and one spindle cell lipoma. PCNA and ki-67 expression indexes were higher in spindle cell lipoma, intramuscular lipomas and fibrolipomas compared to common lipomas, but the differences were not statistically significant. All lesions were removed surgically and none showed recurrence, regardless of the various proliferative activities.
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            Anatomical structure of the buccal fat pad and its clinical adaptations.

            Before performing plastic and aesthetic surgery around the buccal area, the authors reviewed the anatomical structures of the buccal fat pad in 11 head specimens (i.e., 22 sides of the face). The enveloping, fixed tissues and the source of the nutritional vessels to the buccal fat pad and its relationship with surrounding structures were observed in detail, with the dissection procedure described step by step. The dissection showed that the buccal fat pad can be divided into three lobes-anterior, intermediate, and posterior-according to the structure of the lobar envelopes, the formation of the ligaments, and the source of the nutritional vessels. The buccal, pterygoid, pterygopalatine, and temporal extensions (superficial and profound) are derived from the posterior lobe. The buccal fat pad is fixed by six ligaments to the maxilla, posterior zygoma, and inner and outer rim of the infraorbital fissure, temporalis tendon, or buccinator membrane. Several nutritional vessels exist in each lobe and in the subcapsular vascular plexus forms. The buccal fat pads function to fill the deep tissue spaces, to act as gliding pads when masticatory and mimetic muscles contract, and to cushion important structures from the extrusion of muscle contraction or outer force impulsion. The volume of the buccal fat pad may change throughout a person's life. Based on the findings of the dissections, the authors provide several clinical applications for the buccal fat pad, such as the mechanism of deepening the nasolabial fold and possible rhytidectomy to suspend the anterior lobe upward and backward. They suggest that relaxation, poor development of the ligaments, or rupture of the buccal fat pad capsules can make the buccal extension drop or prolapse to the mouth or subcutaneous layer. As such, the authors refined their methods and heightened their focus when using the buccal fat pad to perform a random or pedicled buccal fat pad fat flap or to correct a buccal skin protrusion or hollow.
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              The reconstruction of oral defects with buccal fat pad.

              1) To evaluate the success of buccal fat pad used in the reconstruction of oral defects, 2) to clarify its indications and size limitations, 3) to identify risk factors if there were any. In this prospective clinical study, buccal fat pad was used in 26 patients with different indications which included 5 defects resulting from tumour excisions, 3 maxillary cysts, 3 secondary maxillary cyst defects and 15 oro-antral communications. All defects were in the maxilla with a maximum size of 5x 3 cm. Patients were evaluated for signs of flap epithelialisation, infection, fistulae recurrence and facial contour deficiency. The epithelialisation process was completed after 3 to 4 weeks without any complications in 22 patients. However, partial dehiscence of the graft occurred in 2 patients with large maxillary defects. We also observed serious bleeding during the operation of one of our cases. Because of the small fistula, 1 patient was re-operated. The results of this series support the view that the use of buccal fat pad is a simple, convenient, and reliable method for the reconstruction of small to medium-sized oral defects.
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                Author and article information

                Contributors
                fmaaa2006@yahoo.com
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                13 April 2023
                April 2023
                : 11
                : 4 ( doiID: 10.1002/ccr3.v11.4 )
                : e7201
                Affiliations
                [ 1 ] Department of Maxillofacial Surgery, School of Medicine Ibb University of Medical Sciences Ibb Yemen
                [ 2 ] Department of General Surgery, School of Medicine Ibb University of Medical Sciences Ibb Yemen
                [ 3 ] Department of Urology, School of Medicine Ibb University of Medical Sciences Ibb Yemen
                [ 4 ] Department of Internal Medicine, Faculty of Medicine Hadhramaut University Hadhramaut Yemen
                Author notes
                [*] [* ] Correspondence

                Faisal Ahmed, Urology Office, Al‐Thora General Hospital, Alodine Street, Ibb, Yemen.

                Email: fmaaa2006@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0002-9074-4171
                https://orcid.org/0000-0001-6132-623X
                https://orcid.org/0000-0001-7188-2715
                https://orcid.org/0000-0002-9576-2408
                https://orcid.org/0000-0003-1729-1193
                https://orcid.org/0000-0001-5379-6741
                https://orcid.org/0000-0001-8797-6329
                Article
                CCR37201 CCR3-2023-01-0175.R1
                10.1002/ccr3.7201
                10099198
                b9be3459-4cb8-464e-9201-cdb3c259a618
                © 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 25 March 2023
                : 27 January 2023
                : 29 March 2023
                Page count
                Figures: 3, Tables: 0, Pages: 4, Words: 1994
                Categories
                Case Report
                Case Report
                Custom metadata
                2.0
                April 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:13.04.2023

                buccal fat pad,case report,herniation,infant,trauma
                buccal fat pad, case report, herniation, infant, trauma

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