Tumors of the Buccal Mucosa and Alveolus

Abstract

The buccal mucosa complex essentially consists of the buccal mucosa (BM), gingivo-buccal sulcus (GBS), lower alveolus, and retromolar trigone (RMT). The buccal complex consists of four layers starting with the mucosa, buccinator muscle, subcutaneous tissue, and skin (in to out). The branches of the facial nerve run in subcutaneous tissue planes over the buccinator muscle. The average distance within mucosa and skin is approximately 1–1.5 cm, and it is very easy for infiltrating tumors to travel across and involve the outermost level. The GBS is located at the junction of the buccal mucosa reflecting over the alveolus. The cancer occurring at this site is very common in the Indian subcontinent due to the habit of tobacco chewing. The retromolar trigone has a unique anatomy with potential for tumor spread into the masticator space. The RMT is bounded below and above by the alveolar ridge, medially by the tonsil, and laterally by the buccal mucosa. It is the third dimension – the base that holds the key to the tumor spread. The mucosa lies directly on ascending ramus of the mandible. The masseter muscle lies lateral to the mandible, and the medial pterygoid muscle lies medial to the mandible with lingual and inferior alveolar nerve running through its substance. The temporalis muscle gets inserted on the coronoid process, and the lateral pterygoid muscle occupies the top half of the masticator space.