Traumatic Buccal Fat Pad Herniation in Young Children: A Systematic Review and Case Report

Abstract Purpose Traumatic herniation of a buccal fat pad, predominantly seen in young children, is a rare condition. Due to its rarity and clinical features bearing resemblance to tumors, clinicians are faced with challenges in initial diagnosis. The purpose of this study, along with a systematic review of literature on buccal fat pad herniation management, reports a case showing excellent long-term prognosis following surgical relocation and conservative treatment option. Methods Through PubMed search, 811 articles were initially identified. Case series, case reports, technical notes, case and review report and retrospective case series were included. After screening and manual review, it was narrowed down to 35 reports (41 patients) based on the eligibility criteria. Articles were considered qualified if the standard criteria for traumatic intraoral herniation of buccal fat pad are met. Results Age ranged from 4 months to 12 years with no specific gender predilection. Management consisted of excision (82.9%), relocation (14.6%) and observation (2.4%). Follow-up ranged from 1 week to 4 months. No reports presented a follow-up of over 4 months hence data on long-term prognosis was not reported. In regards to our case report, a 19-month old, male patient, diagnosed with traumatic buccal fat pad herniation was successfully treated with surgical relocation with antibiotic support. 12-month follow-up showed no esthetic, functional disturbance and recurrence. Conclusion Traumatic herniation of the buccal fat pad requires special attention in initial diagnosis. Considering its clinical importance in young children and that few studies reported long-term post-resection follow-up, surgical relocation would be regarded as an excellent and a more conservative treatment option.