The Buccal Mask: Safe Positive Airway Pressure Delivery for Patients with a Paramedian Forehead Flap

The paramedian forehead flap is commonly performed for the reconstruction of complex nasal defects. It typically requires two separate procedures: flap elevation and inset, and then, 2-3 weeks later, pedicle division. In patients with obesity hypoventilation syndrome, the use of positive airway pressure is often mandatory, especially in the postoperative period. However, the face mask used for positive airway pressure has to apply pressure over the bridge of the nose and may compromise the vascularity of a paramedian forehead flap. We report a case where a buccal mask was used successfully in the postoperative period in a patient who needed positive airway pressure after nasal reconstruction with a paramedian forehead flap.