Silberstein Eldad, Krieger Yuval, Shoham Yaron, Arnon Ofer, Sagi Amiram, Bogdanov-Berezovsky Alexander
Department of Plastic Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beersheba 84101, Israel.
ScientificWorldJournal. 2014 Feb 4;2014:219728. doi: 10.1155/2014/219728. eCollection 2014.
Squamous cell carcinoma is a common tumour of lower lip. Small defects created by surgical resection may be readily reconstructed by linear closure or with local flaps. However, large tumours resection often results with microstomia and oral incompetence, drooling, and speech incomprehension. The goal of this study is to describe our experience with composite free radial forearm-palmaris longus tendon flap for total or near total lower lip reconstruction.
This procedure was used in 5 patients with 80-100% lip defect resulting from Squamous cell carcinoma. Patients' age ranged from 46 to 82 years. They are three male patients and two female. In 3 cases chin skin was reconstructed as well and in one case a 5 cm segment of mandible was reconstructed using radius bone. In one case where palmaris longus was missing hemi-flexor carpi radialis tendon was used instead. All patients tolerated the procedure well.
All flaps totally survived. No patient suffered from drooling. All patients regained normal diet and normal speech. Cosmetic result was fair to good in all patients accept one.
We conclude that tendino-fasciocutaneous radial forearm flap for total lower lip reconstruction is safe. Functional and aesthetic result approaches reconstructive goals.
鳞状细胞癌是下唇常见的肿瘤。手术切除造成的小缺损可通过直线缝合或局部皮瓣轻松修复。然而，大肿瘤切除往往导致小口畸形、口腔功能不全、流口水和言语不清。本研究的目的是描述我们使用游离桡骨前臂-掌长肌腱复合皮瓣进行全下唇或近全下唇重建的经验。
该手术用于5例因鳞状细胞癌导致80%-100%唇缺损的患者。患者年龄在46至82岁之间。其中男性3例，女性2例。3例同时重建了颏部皮肤，1例使用桡骨重建了5厘米长的下颌骨段。1例掌长肌缺失的患者使用桡侧腕屈肌腱半腱替代。所有患者对手术耐受性良好。
所有皮瓣均完全存活。无患者出现流口水现象。所有患者恢复了正常饮食和正常言语。除1例患者外，所有患者的美容效果均为尚可至良好。
我们得出结论，游离桡骨前臂腱膜皮瓣用于全下唇重建是安全的。功能和美学效果接近重建目标。
