Sphincter-Sparing Excision and Reconstruction Using Facial Artery Perforator Flaps for Lower Lip Carcinoma.

PURPOSE

This article discusses the results of orbicularis oris muscle-sparing surgery and reconstruction of defects through the use of facial artery perforator flaps and mucosal advancement flaps.

PATIENTS AND METHODS

Patients with lower lip carcinoma were evaluated retrospectively. Patients who underwent reconstruction with facial artery perforator flaps and mucosal advancement flaps with clear surgical margins and no muscle invasion were included in this study. Frozen section examinations were performed intraoperatively. Patients with muscle invasion were excluded.

RESULTS

Between 2005 and 2015, 42 patients were treated by the described method. Supraomohyoid lymph node dissections were performed in patients whose ultrasonography had detected suspicious lymph nodes (n = 4). No metastases were identified on pathologic examination of the lymph nodes, and no local or distant recurrences were seen during a mean follow-up time of 58.4 months (range, 16 to 82 months).

CONCLUSIONS

The value of resecting the orbicularis oris muscle in cases in which there has been no muscle invasion is an ongoing subject of debate among surgeons. Preserving the muscle means preserving the function, and this is the main purpose of reconstruction. Using facial artery perforator flaps for reconstruction ensures good esthetic results while also maintaining the maximum oral opening. Sphincter-sparing excision and reconstruction with facial artery perforator flaps comprise a safe and reliable treatment method for selected cases involving lower lip carcinomas.