Buccal Mucosal Grafting in the Larynx

Endoscopic buccal mucosal grafting (EBMG) has a unique role in the surgical armamentarium of the laryngologist asked to treat laryngeal cancer, papilloma, and stenosis. EBMG can be used to reconstruct anterior glottis webs, repair stenosis, or, in selected cases, as primary soft tissue reconstruction after cancer resection. The two staged procedures are done as out-patient procedures two weeks apart. The first stage requires the donor site’s preparation, harvesting the buccal mucosa, mounting the mucosa on a Silastic sheet, and securing the graft by suture and Silastic stents. The second stage removes the Silastic stents, and surgery is done to shape the graft. The surgery is successful in patients without prior radiation therapy and with good blood supply. It should be used with care in cancer patients as a buccal graft covering the cancer site may be a concern.