Vitagliano Tiziana, Curto Lucia Stella, Greto Ciriaco Antonio, Gareri Pietro, Ribuffo Diego, Greco Manfredi
*Department of Experimental and Clinical Medicine, University "Magna Græcia" of Catanzaro, Catanzaro†Department of Surgery "P Valdoni," University of Rome La Sapienza, Rome, Italy.
J Craniofac Surg. 2016 Nov;27(8):1995-2000. doi: 10.1097/SCS.0000000000003087.
The lips are a common site prone to squamous cell carcinomas, which arise in the facial region. There are different techniques to reconstruct the excised lip region, according to dimensions, area, and position of the tumor. The authors describe a new technique of lip reconstruction born from a combination between a nasolabial flap and adipose tissue transplant.
The study was lead in the Plastic and Reconstructive Surgery Department of the University of Catanzaro. It includes 10 patients with squamous and basal cell carcinomas that interested lower or upper lip. The authors used a nasolabial flap to reconstruct two-thirds of the excised lip. All patients were staged and resulted free of disease. As a result of surgery, deformities and depressions persisted in 5 patients. This induced the authors to subject them to transplantation of adipose tissue to maximize results. Aesthetic and functional evaluation was performed with the Patient and Observer Scar Assessment Scale v 2.0 and drooling rating scale questionnaires. Moreover, an anthropometric analysis was performed in patients treated with fat transplant. Data were analyzed using Wilcoxon signed-rank test.
All patients had an acceptable aesthetic and functional outcome. Oral competence, sensation, and movements of the area were adequate and aesthetic was good. Adipose tissue transplant compared with surgery alone, determine a real modification of various parameters, that was statistically significant (P = 0.043) to our analysis.
The inverted nasolabial flap is versatile and simple. This technique allows to repair large lip defects by maintaining the eurythmia of the face. Autologous fat transplant is a favorable filler. Our data show that surgery alone is unable to restore face eurythmia after a tumor excision. Adipose tissue transplant allows to reach this goal. These 2 techniques, together, may significantly modify the functional and aesthetic result of the lip reconstruction, ensuring an optimal long-term result.
唇部是面部区域常见的鳞状细胞癌好发部位。根据肿瘤的大小、面积和位置，有不同的技术用于重建切除后的唇部区域。作者描述了一种由鼻唇瓣和脂肪组织移植相结合产生的唇部重建新技术。
该研究在卡坦扎罗大学整形与重建外科进行。研究纳入了10例下唇或上唇患有鳞状细胞癌和基底细胞癌的患者。作者使用鼻唇瓣重建切除唇部的三分之二。所有患者均进行了分期且结果显示无疾病。手术结果显示，5例患者仍存在畸形和凹陷。这促使作者对他们进行脂肪组织移植以优化效果。使用患者和观察者瘢痕评估量表v 2.0和流涎评分量表问卷进行美学和功能评估。此外，对接受脂肪移植治疗的患者进行了人体测量分析。数据采用Wilcoxon符号秩检验进行分析。
所有患者的美学和功能结果均可接受。该区域的口腔功能、感觉和运动均正常，美学效果良好。与单纯手术相比，脂肪组织移植确实改变了各种参数，经我们分析具有统计学意义（P = 0.043）。
倒置鼻唇瓣用途广泛且操作简单。该技术能够通过保持面部的匀称性来修复较大的唇部缺损。自体脂肪移植是一种理想的填充材料。我们的数据表明，单纯手术无法在肿瘤切除后恢复面部匀称性。脂肪组织移植能够实现这一目标。这两种技术结合使用，可能会显著改善唇部重建的功能和美学效果，确保长期效果最佳。
