Rahpeyma Amin, Khajehahmadi Saeedeh
Oral and Maxillofacial Diseases Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
J Craniofac Surg. 2013 Jul;24(4):1179-83. doi: 10.1097/SCS.0b013e318299729a.
The lower vermilion cross-lip flap is usually indicated for large upper-lip vermilion defects. This article points out the importance of the donor site incision and reveals the significance of incorporation of inferior labial artery in this flap.
The cadaveric study was designed to measure the vertical distance between the upper most parts of the inferior labial artery to vermilion surface in 22 fresh male cadavers. Tissue specimens were taken from the lower lip at the midline in the sagital plane. Moreover, the histologic sections were stained with hematoxylin-eosin, and the measurements were done under light microscope. Alternatively, the divided-pedicle group study consists of 6 patients with lower vermilion cross-lip flap, in which the pedicles were sent to the laboratory for histologic examination after pedicle division.
The distance between the inferior labial artery and the upper most part of the vermilion border was 2.42 ± 1.67 mm. In 77.27% of cases, the artery was found in the submucosal layer. The histologic examination of the pedicles in 6 patients showed the presence of inferior labial artery, in hematoxylin-eosin staining, in the serial cross sections of 5 pedicles.
Four-millimeter-deep incision of the lower lip's vermilion will embody the inferior labial artery in lower vermilion cross-lip flap in most of the cases. Moreover, the histologic study of the pedicles revealed that the incorporation of the inferior labial artery in flap pedicle will ensure flap perfusion.
下唇交叉唇瓣通常适用于较大的上唇唇红缺损。本文指出了供区切口的重要性，并揭示了在下唇交叉唇瓣中纳入下唇动脉的意义。
尸体研究旨在测量22具新鲜男性尸体中下唇动脉最上部至唇红表面的垂直距离。在矢状面的中线处取下唇组织标本。此外，组织切片用苏木精-伊红染色，并在光学显微镜下进行测量。另外，分蒂组研究包括6名下唇交叉唇瓣患者，其中在蒂部分离后将蒂部送去进行组织学检查。
下唇动脉与唇红缘最上部之间的距离为2.42±1.67毫米。在77.27%的病例中，动脉位于黏膜下层。对6例患者蒂部的组织学检查显示，在5个蒂部的连续横切片中，苏木精-伊红染色显示存在下唇动脉。
下唇唇红4毫米深的切口在大多数情况下会在下唇交叉唇瓣中包含下唇动脉。此外，对蒂部的组织学研究表明，在瓣蒂中纳入下唇动脉将确保瓣的血供。
