A regional approach to reconstruction of the upper lip.

PURPOSE: This articles reviews the results obtained when cheek or lower lip flaps, or a combination of these flaps, are used for the reconstruction of defects of the upper lip. PATIENTS AND METHODS: Twenty-four cases of either partial or total full-thickness defects of the upper lip were reconstructed. Four cases with lateral full-thickness partial defects were reconstructed by advancing a cheek flap using the Bernard-Burow method. In five cases, defects located at the junction of the upper lip and the cheek were reconstructed with an Estlander flap. Four patients with a tight upper lip were corrected with an Abbé flap. In two cases, a modified mucomuscular Abbé flap was used for reconstruction of a vermilion defect of the upper lip. Nine patients with subtotal or total full-thickness defects of the upper lip were reconstructed with a combination of bilateral or unilateral cheek flaps using either the Bernard-Burow or Dieffenback method and T-shaped or oblong Abbé flap. RESULTS: All regional flaps healed uneventfully, and the function of reconstructed upper lips had recovered within 2 years postoperatively. CONCLUSION: Use of regional flaps to reconstruct partial or total full-thickness defects of the upper lip can usually achieve satisfactory functional and esthetic results.

Secondary closure of oroantral and oronasal fistulas: a modification of existing techniques.

Fifty-three patients, 25 with oroantral and 28 with oronasal fistulas, were treated using a modified technique of peripheral de-epithelialization and overlapping flaps. This technique was used with sliding buccal flaps, palatal rotation flaps, palatal island flaps, tongue flaps, and distant tubed pedicle flaps. The advantage of the flap is that it provides more tissue attachment, which promotes healing and resists the tendency of the flap to return to its original position. A high degree of success can be predicted. Only two failures were observed in 53 cases.