RESUMO
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.
RESUMO
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.