Roldán J Camilo, Teschke Marcus, Fritzer Elfriede, Dunsche Anton, Härle Franz, Wiltfang Jörg, Terheyden Hendrik
Regensburg, Bonn, Karlsruhe, and Kiel, Germany From the Departments of Oral and Maxillofacial Surgery, University of Regensburg and University of Bonn, Department of Oral and Maxillofacial Surgery, Institute of Medical Informatics and Statistics, University Schleswig-Holstein, Campus Kiel, and Department of Oral and Maxillofacial Surgery, General Hospital Karlsruhe.
Plast Reconstr Surg. 2007 Oct;120(5):1231-1239. doi: 10.1097/01.prs.0000279147.73273.e9.
The boundaries of the aesthetic units of the face are often crossed after lower lip cancer surgery. The aim of this study was to compare the aesthetic and functional outcome after use of different operative techniques based on the concept of the aesthetic units of the face.
Sixty-three patients were evaluated after lower lip reconstruction. The aesthetic outcome was recorded by standard photography evaluating the disruption of the boundaries of the aesthetic units of the face, lip projection, and the resulting facial expression. The functional outcome consisted of the evaluation of mouth opening, pouting, and lips at rest for the evaluation of mouth continence. Three techniques were used: wedge excision, the Webster-Fries method, and the step technique. The step technique was combined with an Abbé or an Estlander flap in defects involving more than two-thirds of the lip.
In defects involving up to one-third of the lip, the aesthetic outcome was better for the step technique than for wedge excision (a statistical trend was observed, p = 0.088). In defects involving two-thirds of the lip, the aesthetic and functional outcome was better using the step technique than the Webster-Fries method (p = 0.002), because the boundaries of the aesthetic units are respected. In defects involving more than two-thirds of the lip, the result was better using the step technique combined with the Abbé flap.
The authors have shown that the step technique alone or combined with a flap of the opposite lip is a rational approach for preserving the aesthetic units of the face and its function.
下唇癌手术后，面部美学单元的边界常被跨越。本研究的目的是基于面部美学单元的概念，比较使用不同手术技术后的美学和功能结果。
对63例下唇重建术后的患者进行了评估。通过标准摄影记录美学结果，评估面部美学单元边界的破坏、唇部突出度及由此产生的面部表情。功能结果包括评估张口、撅嘴以及静止时唇部情况以评价口部节制功能。使用了三种技术：楔形切除术、韦伯斯特 - 弗里斯法和阶梯技术。在涉及超过三分之二唇部的缺损中，阶梯技术与阿贝瓣或埃斯特兰德瓣联合使用。
在涉及至多三分之一唇部的缺损中，阶梯技术的美学结果优于楔形切除术（观察到统计学趋势，p = 0.088）。在涉及三分之二唇部的缺损中，使用阶梯技术的美学和功能结果优于韦伯斯特 - 弗里斯法（p = 0.002），因为面部美学单元的边界得到了尊重。在涉及超过三分之二唇部的缺损中，阶梯技术联合阿贝瓣的效果更好。
作者表明，单独的阶梯技术或与对侧唇部皮瓣联合使用是一种保留面部美学单元及其功能的合理方法。
