ABSTRACT
Objective To design a new vermilion musculomucosal flap to reconstruct the normal appearance of unilateral cleft lip,and to analyze the clinical effects.Methods All patients were repaired with Millard method,and vermilion musculomucosal flap was formed with fixed point method to repair vermilion.Normal function and morphology were recovered by reconstructing lip beads and forming a peak of cupid's bow.Results 78 cases were enrolled in this study.They were followed-up for 6 to 36 months after operation.Except for 6 cases of nasal deformity and 5 mild lift of vermilion of affected side,67 cases obtained satisfied nasolabial form and function,with full decline and symmetry of cupid's bow peak,and well form of nasolabial fold,and natural transition of vermilion,and significance of lip beads,and inconspicuous scars.Conclusions Appling vermilion musculomucosal flap for reconstructing vermilion of unilateral cleft lip has good effect,and it is simple and feasible.It can be a regular surgery method,and is worthy of clinical promotion.
ABSTRACT
The purpose of this article is to review the method using the mucosal island flap for the reconstruction of upper and lower lip defect and introduce its versatile applications and advantages. This flap is based on the inferior labial artery as the axial pedicle and is composed of musosa only, excluding muscle to give a sufficient rotation arc of the flap. Mucosal island flap is effective for the reconstruction of vermilion, because the mucosa of the flap is similar to the lip, with its color and texture matched well. Four patients with various large defects of vermilion underwent the reconstruction with mucosal island flaps. Two patients were presented with venous malformations and others were admitted with lip deformities caused by traffic accident or operation for basal cell carcinoma. Elevation of flap is simple and safe in maintenance with the interdental wire fixation to prevent the pedicle from being stretched and, primary closure is available in donor site under local anesthesia. Therefore, mucosal island flap can be recommended as an effective and reliable method for the reconstruction of over one-third defect of vermilion.