{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:22:40Z","timestamp":1783106560761,"version":"3.54.6"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The posterior-based buccinator myomucosal flap is a reliable option for reconstructing posterior oral defects, though pedicle transfer methods vary. This prospective study compared functional outcomes, complications and burden of care between tunnelling and non-tunnelling techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Patients were randomised into Group A (tunnelling,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20; single-stage) and Group B (non-tunnelling,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20; two-stage). Primary outcomes were flap survival and need for secondary surgery. Secondary outcomes included trismus, oral opening and mobility. Data were analysed using independent\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and Fisher\u2019s exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Flap survival was comparable (95% vs. 100%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.000). However, the non-tunnelling group required a second surgery and had significantly longer hospital stays (4.0 vs. 2.0 days;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). At 6 months, the tunnelling group achieved substantially greater maximum oral opening (39 mm vs. 33 mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008), despite higher rates of venous congestion (25% vs. 5%) and trismus (15% vs. 5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The tunnelling technique is superior for operative efficiency, offering a single-stage reconstruction that avoids the morbidity and cost of a second operation. While simpler initially, the non-tunnelling technique necessitates a second stage and results in greater long-term limitation of mouth opening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ams.ams_250_25","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:00:22Z","timestamp":1783105222000},"page":"15-19","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Tunnelling Versus Non-tunnelling Techniques in Posterior-based Buccinator Myomucosal Flap Reconstruction - A Prospective Study"],"prefix":"10.4103","volume":"16","author":[{"given":"Hamdan Saadi","family":"Abbas","sequence":"first","affiliation":[{"name":"Department of General Surgery, Maxillofacial Unit, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Omar Mahmoud","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and ICU, New Valley University, Kharga, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diaa El-Dein Saber","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Maxillofacial Unit, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"R1-20260703","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/MOO.0000000000000884","article-title":"Intraoral flaps for oral cavity and oropharyngeal reconstruction","volume":"31","author":"Sandilands","year":"2023","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"R2-20260703","doi-asserted-by":"crossref","first-page":"7766","DOI":"10.3390\/jcm13247766","article-title":"New classification system and defect-oriented 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reconstruction in oral cavity cancers","volume":"31","author":"Karabulut","year":"2020","journal-title":"South Clin Istanb Eurasia"},{"key":"R10-20260703","doi-asserted-by":"crossref","first-page":"2021","DOI":"10.1097\/SCS.0000000000004610","article-title":"The arterialized facial artery musculo-mucosal island flap for post-oncological tongue reconstruction","volume":"29","author":"Moro","year":"2018","journal-title":"J Craniofac Surg"},{"key":"R11-20260703","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.bjoms.2016.12.008","article-title":"Versatility of buccinator flaps for the treatment of palatal defects: A series of cases","volume":"55","author":"Gavin Clavero","year":"2017","journal-title":"Br J Oral Maxillofac Surg"},{"key":"R12-20260703","doi-asserted-by":"crossref","first-page":"4202","DOI":"10.3390\/app11094202","article-title":"Facial artery myomucosal flap versus islanded facial artery myomucosal flap viability: A systematic 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