A new approach for repair of oro-antral-nasal fistulae.  The anteriorly based buccinator myomucosal island flap. 
Oral-antral-nasal fistula (OAN) is a commonly encountered clinical problem.  The literature is filled with a plethora of methods described for closing a persistent OAN.  Local flaps are available to close minor to moderate defects, however, large fistulae can be a very challenging reconstructive problem.  Various areas of the oral cavity have been used for closure of OAN.  We describe a technique to reconstruct the oral cavity, in this case an OAN.  The anteriorly based buccinator myomuosal island pedicle flap (BMIP) provides an alternative method for reconstructing the oral cavity.  An extensive review of the literature as well as the anatomy of the buccinator, its reconstructive capabilities, and two case reports are included.