As the goal of reconstruction is both a good functional and aesthetic result, lesions larger then 70% of the lower lip … Total Lower Lip Reconstruction With Functional Gracilis Free Muscle Flap. It is because of the difficulty in regaining the function of the lip, including the oral competency and restoring the aesthetic subunit. Modified Von Bruns' Technique for Total Lower Lip Reconstruction Modified Von Bruns' Technique for Total Lower Lip Reconstruction Adler, Neta; Amir, Abraham; Hauben, Daniel 2004-03-01 00:00:00 THE TREATMENT of carcinoma of the lower lip is primarily surgical. Lip defects can be classified according to thickness of the defect (ie, skin or mucosa only, full-thickness) and overall size of the defect. P.178 Total lower lip reconstruction, with local flaps, after tumor excision Google Scholar; 12. The challenge faced by surgeons is to re-create not only an esthetically pleasing lower lip but also, more importantly, a lip that is functional. Total lower lip and chin defect following arteriovenous malformation (AVM) excision. Plast Reconstr Surg. In two other patients, the cancer ablation included more than 80 percent of the lower lip and up to 40 percent of the upper lip. The scalp visor flap offers a simple but extremely versatile tool for use in midfacial reconstruction, especially in the male, providing neo-lip tissue, a moustache and a beard. Karapandzic and Bernard Burrow Webster Flap Amalgamation in Reconstruction of Near-Total Defect of the Lower Lip N Naveen 1 , T S Purushotham 1 , H R Pallavi 2 , Hanumantha Basappa Vaggara 2 1 Assistant Professor, Department of Plastic and Reconstructive Surgery, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India, Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction; therefore, several different options should be available for each defect. The authors present a reconstruction of the lower lip combining two classical flaps: the Karapandzic and Bernard–Burrow–Webster flap. Total lower lip reconstruction with a sensate composite radial forearm—palmaris longus free flap and a … Total Lower Lip Reconstruction Using Free Neurotendinofasciocutaneous Anterolateral Thigh Composite Flap: A Case Report. This is the first report of a simultaneous total upper and lower lip reconstruction using a scalp visor flap, in the English literature. In three cases, bilateral extended Karapandzic flaps were used for total lower lip defects, and in five additional cases, unilateral extended Karapandzic flaps were combined with other local flaps for near-total … res the matching of vermilion color, maintenance of oral sphincter function and mouth opening size, and retention of sensation. A radial forearm palmaris longus free flap was used in all cases for reconstruction … Ten cases of total lower lip reconstruction are reviewed. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patient's age, sex, occupation, and general health. A radial forearm palmaris longus free flap was used in all cases for reconstruction … Results: Eight patients underwent successful single-stage lower lip reconstruction with this technique. Surgical reconstruction of total lower lip and chin defects because of their large size require reconstruction with distant flaps. ap for total or near total lower lip reconstruction. After tumor resection on the lower lip, the fasial arter, vein and marginal mandibular nerve are prepared as recipient vessels and nerve. Lower lip reconstruction strategies patient had a lesion covering 90% of the lower lip that was reconstructed using the Webster-Bernard technique and a tongue flap (Figure 7, Table 1). The total lip defects resulted from tumor resection (n=6), trauma (n=3), and noma (n=1). Composite anterolateral thigh-fascia lata flap: a good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction. They also report that Delpech used a large superiorly based anterior cervical flap to achieve Objective. • Facial vessels are left intact. (2)Department of Otorhinolaryngology, Faculty of Medicine, Ataturk University, Erzurum, Turkey. Lip carcinoma is a common cancer of the head and neck region. 2013 May 13. . Total to near-total resection (more than 80 percent) of the lower lip was indicated in six patients. Gurunluoglu R, Glasgow M, Williams SA, Gurunluoglu A, Antrobus J, Eusterman V. J Plast Reconstr Aesthet Surg, 65(10):1335-1342, 29 … They are summarized below: Minor reconstruction. Reconstruction after resection of large tumors of the lower lip requires the use of free flaps in order to restore the shape and the function of the lip, with the free radial forearm flap being the most popular. Near total lower lip defect with involvement of adjacent chin soft tissue Proposed resection Folded radial forearm flap with palmaris tendon graft Early postoperative result 46. can J plast surg 2013;21(1):57-61. There are a number of techniques for the one stage reconstruction of these defects. 4. During the years 1986 to 1988, seven patients with advanced squamous cancer of the lower tip were operated on in our department and the defects were reconstructed by the gate-flap technique. 2013 May. [email protected]@gmail.com 82. Materials and methods:We reviewed the possibilities of surgical reconstruction for the total lower lip defects and after assessment of the advantages and disadvantages we have chosen the Camille-Bernard modified technique to treat a series of 11 patients with lower lip tumors. Tellioglu(10), in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free microsurgical flap from the forearm (radial flap), for total reconstruction of the lower lip. (1)Department of Plastic Reconstructive and Aesthetic Surgery. During this period, one patient who underwent reconstruction with a myomucosal flap and In cases chin skin … Total or near total lower lip reconstruction remains a challenge to the reconstructive surgeon. BackGrounD: Reconstruction of extensive lower lip defects is diffi-cult. We present a modification of the Webster flap for total lower lip reconstruction using innervated muscle‐bearing flaps. There are a number of techniques for the one stage reconstructions of these defects. Goals of the reconstruction procedure are to restore patients oral competence, speech, and diet as well as to permit oral hygiene and as normal as possible appearance [6–8].Local flaps often fail to achieve these goals and require numerous revision procedures []. Goals of the reconstruction procedure are to restore patients oral competence, speech, and diet as well as to permit oral hygiene and as normal as possible appearance [ 6 – 8 ]. PURPOSE: The reconstruction of total lower lip defects is very challenging, whether from trauma or after oncologic treatment. We present a modification of the Webster flap for total lower lip reconstruction using innervated muscle-bearing flaps. Patients age ranged from to years. 24(3):984-6. . There were concomitant chin and mandible defects in three and four patients. Defects usually involve the full thickness and include skin, muscle and mucosa. 1991;88:209-214. Minor lip reconstruction surgery includes surgery that is localized to the vermillion border or is considered a small defect, meaning less than 30% of the upper or lower lip is involved. In two other patients, the cancer ablation included more than 80 percent of the lower lip and up to 40 percent of the upper lip. Reconstruction of lateral lower lip defects with transverse lip advancement flap. The types of lip reconstruction are categorized by the size of the defect an individual has. • Mucosal flaps provide vermilion coverage. Discussion. Several techniques have been suggested. The surgical technique is discussed. Tan O, Kuduban SD, Algan S, Cinal H, Barin EZ. J Reconstr Microsurg. Total or near total lower lip reconstruction remains a challenge to the reconstructive surgeon. Several techniques have been suggested. As cited by Mazzola and Lupo,7(p585) historically submandibular flaps were used by Lalle-mand in 1824. Functional reconstruction of total lower lip defects using innervated gracilis flap in the setting of high-energy ballistic injury to the lower face: preliminary report. • Revisional surgeries are often required • More chances of upper lip denervation. Goals of the reconstruction procedure are to restore patients oral competence, speech, and diet as well as to permit oral hygiene and as normal as possible appearance [6-8]. J Craniofac Surg. Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively. We found that this method affords satisfactory total reconstruction of the lower lip. Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. ey are three male patients and two female. is procedure was used in patients with % lip defect resulting from Squamous cell carcinoma. series of 11 patients with lower lip tumors. Total to near-total resection (more than 80 percent) of the lower lip was indicated in six patients. It more often affects the lower lip (> 90%), and squamous cell carcinoma represents 95% of the cases. Sakai S, Soeda S, Endo T, Ishii M, Uchiumi E. A compound radial artery forearm flap for the reconstruction of lip and … Reconstruction of total lower lip and chin defects using the composite radial forearm—palmaris longus tendon free flap. Fugimori’s Gate flapsFugimori’s Gate flaps • Used for total lower lip reconstruction. Patients and Methods. Hs singh. Arch Facial Plast Surg 2000;2:53-6. To present a surgical technique for the reconstruction of total lower lip defects after excision of … The authors describe a new technique of one-stage total lower lip reconstruction, with the ultimate goal being achievement of the delicate We recently presented our experience in reconstruction of total or subtotal lower lip defects due to SCC excision with functional gracilis muscle flap covered STSG in our series of 8 cases [24]. a new technique for one-stage total lower lip reconstruction: achieving the perfect balance. Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. Subtotal reconstruction of the lower lip after excision of the tumor is always a challenge for surgeons. Reconstruction of the lower lip and chin with the composite radial forearm—palmaris longus free flap. Total or near total lower lip reconstruction remains a challenge to the reconstructive surgeon. Barron & Saad(l), in 1990, described the use of the platysma musculocutaneous flap for total lower lip reconstruction. Template for folded radial forearm flap. Major reconstruction Serletti JM, Tavin E, Moran SL, Coniglio JU. 9. A 46-year-old patient presented with an ulceroproliferative growth involving 70% of the lower lip, including the right commissure. Total lower lip reconstruction was accomplished by combining a radial forearm free flap with a masseter muscle transfer. The authors present a reconstruction of the lower lip combining two classical flaps: the Karapandzic and Bernard-Burrow-Webster flap. Defects usually involve the full thickness and include skin, muscle and mucosa.
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