Dediol Emil, Čvrljević Igor, Dobranić Marijan, Uglešić Vedran
Assistant Professor, School of Medicine, University of Zagreb, Zagreb; Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Resident, Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
J Oral Maxillofac Surg. 2018 Jan;76(1):213-220. doi: 10.1016/j.joms.2017.06.015. Epub 2017 Jun 23.
Near total defect of the lower lip adjacent to the chin remains a reconstructive challenge for surgeons in function and esthetics. The objective of this study was to present a modified extended Karapandzic technique for reconstruction of near total defects of the lower lip adjacent with the chin.
From 2000 to 2013, patients with lip cancer or oral cavity cancer who required subtotal lower lip and chin resection and subsequently underwent reconstruction with an extended Karapandzic flap were included in this retrospective study. Patient demographics, histopathology, tumor stage, localization, tumor extension, method of reconstruction, and postoperative complications were extracted from patients' documentation.
Reconstruction of the lower lip and chin was performed in 21 patients using a combination of double local extended Karapandzic flaps with microvascular free flaps for intraoral and mandibular reconstruction. There was no flap necrosis; the main complications were fistula and exposure of the osteosynthesis plate. All lips were functional and the esthetic result was pleasing. All patients returned to a peroral diet, although a variable degree of microstomia was present.
The extended Karapandzic flap technique provides superior results for esthetic and functional lip reconstruction and chin reconstruction compared with any other regional or free flap. Free flaps should be reserved for oral cavity and mandibular reconstruction, if needed.
靠近下巴的下唇近全层缺损在功能和美观方面对外科医生来说仍是一个重建挑战。本研究的目的是介绍一种改良的扩展卡拉潘齐克技术，用于重建靠近下巴的下唇近全层缺损。
对2000年至2013年间因唇癌或口腔癌需要进行下唇和下巴次全切除，随后采用扩展卡拉潘齐克皮瓣进行重建的患者进行了这项回顾性研究。从患者病历中提取患者人口统计学资料、组织病理学、肿瘤分期、定位、肿瘤扩展情况、重建方法及术后并发症。
21例患者采用双局部扩展卡拉潘齐克皮瓣联合游离微血管皮瓣进行口腔内和下颌骨重建，以重建下唇和下巴。未出现皮瓣坏死；主要并发症为瘘管和接骨板外露。所有唇部功能良好，美观效果令人满意。所有患者均恢复经口进食，尽管存在不同程度的小口畸形。
与其他区域皮瓣或游离皮瓣相比，扩展卡拉潘齐克皮瓣技术在唇部和下巴的美观及功能重建方面效果更佳。如有必要，游离皮瓣应留用于口腔和下颌骨重建。
