Comparison of clinical effects of the Yu flap and the Karapandzic flap in repairing greater than 2/3 lower lip defects / 口腔疾病防治

Objective@#To compare the clinical effect of the Yu flap and the Karapandzic flap in repairing greater than 2/3 defects of the lower lip and to provide a reference for clinical application.@*Methods@#Ten patients with greater than 2/3 lower lip defects after surgical resection of lower lip tumors and vascular malformations were enrolled: 5 patients were repaired with the Yu flap (Yu flap group) and 5 patients were repaired with the Karapandzic flap (Karapandzic flap group). Follow-up for at least 1 year was conducted to evaluate the morphology (symmetry, stoma, exposure of vermilion) and function (sensory function, motor function) of the reconstructed lower lip.@*Results @#All the flaps survived, and all wounds showed primary healing. The lower lips reconstructed with the Yu flap or the Karapandzic flap obtained similar satisfactory oral function. The sensory function was essentially restored. There were no obvious obstacles in speech and expression, and no saliva leakage occurred. In the Yu flap group, only 1 patient had slight microstomia. In the Karapandzic flap group, 2 patients had slight microstomia and 3 patients had moderate microstomia. 90% (9/10) of the patients were very satisfied with the postoperative outcome, and 1 patient in the Karapandzic flap group was basically satisfied. @*Conclusion@#Both the Yu flap and the Karapandzic flap can be used to repair greater than 2/3 lower lip defects and reliable outcomes can be achieved. These two methods can achieve similar oral functions, but the effect of the Karapandzic flap is inferior to that of the Yu flap in terms of aesthetic appearance, and microstomia often occurs, while the Yu flap can generally maintain the original size of the mouth cleft.

Managing lip large papilloma extirpation defect by arterialized advancement vermilion flap

The close resemblance of squamous papilloma with verrucous carcinoma and the chief etiological factor associated with its development, the human papillomavirus (HPV) raises a doubt about its close association with malignancy. The best way to treat HPV growths is surgical removal and assessment of lesion by histopathology. The defect needs reconstruction with full function and aesthetic outlook. Thirty-seven years old young man with history of tobacco chewing developed slow growing papilloma in upper lip in one year. It was excised fully and the defect was repaired by arterialized lip vermilion mucosal flap based on slightly tortuous labial vessel and so the flap could be elastically stretched even up to fifty percent of lip length and applied successfully. Same patient developed papilloma in lower lip as a separate primary after two years of nonrecurrence of previous operated upper lip papilloma. Lower lip lesion was excised similarly and repaired with same type of vermilion mucosal advancement flap from adjacent part of lower lip defect created. The post-operative period was uneventful and after three years of last operation there is no recurrence in either lip. Vermilion flap which is based on labial artery containing composite tissue comprising of mucosa and portion of orbicularis muscle mainly has been utilized to reconstruct the post excision papilloma lip defect with excellent functional and aesthetic results. There was no microstomia. It is single stage not involving donor site like tongue or cheek mucosa and is good upto half of lower lip defects.

Aesthetic repair of medial upper lip defects / 中华医学美学美容杂志

Objective To explore the aesthetic results of medial upper Iip repair for skin and soft tissue defects using local flap.Methods According to the location and the size of upper lip defect,the modified rhomboid flap of 60 ° above the defect was designed to repair the wound in philtrum;the O-L flap along philtral column to vermilion border was designed to cover the wound close to the peak and lateral to philtral column.Results Twenty-one postoperative patients that underwent pigmented nevus removal (12 female,9 male;ages 16-33 years) had defects in philtrum for 10 cases and close to the peak and philtral column for 11 cases.The diameter of the defect ranged from 0.5 cm to 1.0 cm.All flaps survived primarily without any complications and follow-up was for 1 to 18 months with excellent outcomes in all cases.All patients were satisfied with contour and functions.No pigmented nevus recurrence occurred.Conclusions The flap designed according to the aesthetic principle could be used to repair medial upper lip defect of medium-sized,which not only obtains functional reconstruction,but also satisfies aesthetic results,with aesthetic subunits saved and scar concealed.

Observation of effect of red lip defect repair using orbicularis oris muscles pedicle island flap disc / 中国基层医药

Objective To explore the effect of red lip defect repair using orbicularis oris muscles pedicle island flap disc.Methods 100 cases of unilateral pure red lip defect 1/3-2/3,lip lines full of patients were selected as the research subjects.They were randomly divided into two groups,50 cases in each group.Group A treated with debridement surgery to repair.Group B received red lip flap to promote repair treatment.The treatment effect of the two groups, satisfaction, lip survival rate and the degree of obvious scars were compared.Results he operation effect of the two groups was good.The satisfaction rates of group A and group B were 94.00% and 96.00%,respectively.For the lip shape treatment satisfaction, the difference was no statistically significant (P>0.05).The patients of the two groups with lip all alive, and 1 patient in group A with obvious scar, the scar was not obvious in group B.Conclusion For patients with red lip defect, take orbicularis oris muscles pedicle island flap of the oral mucosa or red lip flap to promote repair treatment has relatively significant clinical efficacy, with easy operation, less influence on the patients with facial form, it is worthy of popularizing.

Prosthetic treatment for patient with upper lip cancer and severe periodontitis: Maxillary complete denture with denture adhesive and mandibular double crown-retained removable partial denture / 대한치과보철학회지

When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident(R) denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.

Clinical application of lower cross-lip flap in treatment of upper lip defect / 中华医学美学美容杂志

Objective To evaluate the clinical effect of the upper lip defect with lower cross-lip flap (Abbe-Estlander flap).Methods A total of 68 cases of upper lip defect underwent the reconstruction with cross-lip flaps.We applied Abbe flap in upper lip defect in the center,and Estlander flap in lateral upper lip defect.This method was a two-stage procedure:the first stage was to rotate flap 180 degrees into the upper lip defect and to suture with the created defect of the upper lip,with careful maintenance of blood supply from the pedicle; the second was to undertake the division of bridged pedicle and paid more attention to creation of the vermilion border.Results The flaps survived in all cases.Evaluation from 3 to 12 months after the operation showed that the shape of lips were obviously repaired with excellent aesthetic and functional results.Conclusions Abbe-Estlander flap could reconstruct anatomical features and function of the lip precisely.It seems that within certain limits (probably between one-third and one-half of total upper lip length),this flap appears to be the preferred method for upper lip reconstruction.

Lower Lip Reconstruction Using Various Flap Surgeries

Lower lip defects can result from congenital or acquired problems, such as congenital naevi, hemangioma, tumor, trauma and infectious disease. The principal function of the lip is oral competence. The lips also play a role in deglutition and articulation, as well as being a symbol of beauty and appeal. Defects of up to one third of the lower lip can be closed primarily, but large defects require more complex techniques including distant and free flap reconstruction that have been used with varying degrees of aesthetic and functional success. The authors experienced 10 cases of lower lip reconstruction from July 2002 to March 2003 using V-Y advancement local flap, Abbe flap, double barrel type flap, depressor anguli oris musculocutaneous flap, gracilis musculocutaneous free flap and fibular osteocutaneous free flap combined with forearm fasciocutaneous free flap. The mean age of the patients, 6 males and 4 females, at the time of the procedures was 64.4 years (from 56 to 74 years). Based on our experience, local flap was the best choice for small lower lip defects. However large and total lip defects that do not have normal adjacent tissues required free flap. The disadvantages of the free flap were bulkiness, bad color change, and drooping of the flap. In conclusion, analyzing the results of the various flap surgeries, we could identify the advantages and disadvantages of each type of flaps, which will help us to create the proper method of lower lip reconstruction.