Spanholtz T A, Theodorou P, Phan V, Perbix W, Spilker G
Plastische Chirurgie, Universität Witten/Herdecke, Köln, Germany.
Handchir Mikrochir Plast Chir. 2007 Oct;39(5):350-5. doi: 10.1055/s-2007-965796.
Deep thermal dermal wounds of the oral region with subsequent microstomia are a rare and complex indication for surgical reconstruction of the oral commissure. Apart from functional and mimic aspects, aesthetic expectations are high. Based on converse technique, we performed a reconstruction of the oral commissure in 17 patients. 8 of these needed surgical re-operation due to recurrence and insufficient results. This high rate of complications led to a modification of the surgical procedure.
We present a modified technique which gave good results in our clinic. Based on Fairbank's technique, we altered the technique by covering the soft tissue defect of the lateral lip with an additional rotation flap raised from the mucosa of the enoral lower lip. Resulting scars were thereby shifted to the enoral side of the lower lip which caused less contracture in the region of the oral commissure.
Using this modified technique, we were able to achieve a lasting displacement of the oral commissure to the lateral side. Long-term follow-up showed good functional results with no need for additional procedures.
口腔区域的深度真皮热损伤并继发小口畸形是口腔口角手术重建的一种罕见且复杂的指征。除了功能和表情方面，美学期望也很高。基于反向技术，我们对17例患者进行了口腔口角重建。其中8例因复发和效果不佳需要再次手术。如此高的并发症发生率促使我们对手术方法进行了改进。
我们介绍一种在我们诊所取得良好效果的改良技术。基于费尔班克技术，我们通过从口腔下唇黏膜掀起一个额外的旋转皮瓣来覆盖外侧唇的软组织缺损，从而对该技术进行了改进。由此产生的瘢痕因此转移到了下唇的口腔侧，这在口角区域引起的挛缩较少。
使用这种改良技术，我们能够使口角持久地向外侧移位。长期随访显示功能效果良好，无需额外手术。
