Buccal fat pad (of Bichat)

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A Moment in History

Georg Eduard Von Rindfleisch
(1836 – 1908)

German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999) Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross

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Details: Written by: Efrain A. Miranda, Ph.D.; Published: February 06, 2017; Hits: 5430

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The [buccal fat pad] is dense, fatty trigone-shaped pad that is located in the cheek. It is formed by several connective-tissue encapsulated smaller fat pads. It covers partially the posterior aspect of the buccinator muscle, and is found deep to the anterior portion of the masseter muscle. Also known as “Bichat’s fat pad”, it was first described by Marie-François Xavier Bichat in 1802. It is also known as the suctorial fat pad and it helps in the suction process for breast feeding in infants, although because of its location it is also said to help in the gliding motion of the masticatory and facial expression muscles. The buccal fat pad is well developed in newborns and is not as evident in most adults.

Its anatomical description varies according to the authors, but it has a main body and three extensions, namely the anteromalar (anterior), pterygomaxillary (pterygoid), and temporal (posterotemporal) extensions. The blood supply to the buccal fat pad is by way of the anterior deep temporal, buccal, and posterior superior alveolar arteries.

Excessive development of this fat pad can lead to cosmetic surgery to eliminate, or at least reduce its size. This procedure is known in many countries as a “bichectomy”, Bichatectomy” of “cheek reduction surgery”, in some cases this procedure can be performed intraorally.

The buccal fat pad can also be used in maxillofacial reconstructive surgery, as well as the repair of skull base defects. When dissecting the buccal fat pad, care must be taken because of the relation of this structure with the parotid duct, the parotid gland, and branches of the facial nerve

Sources:
1. “Anatomy of the buccal fat pad and its clinical significance” Jackson, IT Plastic and Reconstructive Surgery, 06/1999, Volume 103, Issue 7
2. "A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad" Yousuf, S et al Surg Radiol Anat (2010) 32:427–436
3. "The Endonasal Endoscopic Harvest and Anatomy of the Buccal Fat Pad Flap for Closure of Skull Base Defects" Markey, J et al The Laryngoscope 125: 2247-2252
4. "Bichectomy or Bichatectomy - A Small and Simple Intraoral Surgical Procedure with Great Facial Results" Eber Luis de L S. Adv Dent & Oral Health. 2015; 1(1): 555555. DOI: 10.19080/ADOH.2015.01.555555.
5. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain

Image: By Otto Placik (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons] Click here for the link to the original image

Buccal fat pad (of Bichat)

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