Gunnarsson Gudjon L, Demmissie Meheret Beferkadu, Havemann Ingemar, Topstad Thom Kare, Thomsen Jorn Bo
Department of Plastic Surgery, Telemark Hospital, Skien, Norway; ALERT Center & Yekatit 12 Hospital, Addis Ababa, Ethiopia; Eminent Surgery, Kristiansand, Norway; and Department of Plastic Surgery, Odense University Hospital and Vejle/Lillebaelt Hospital, Denmark.
Plast Reconstr Surg Glob Open. 2017 Dec 22;5(12):e1607. doi: 10.1097/GOX.0000000000001607. eCollection 2017 Dec.
Total loss of the lower lip is debilitating and poses a reconstructive challenge. Aiming to restore oral continence and function and also cosmetic appearance, a successful reconstruction has a huge impact on the quality of life for the individual patient. Early sources of local tissue rearrangement for lip reconstruction date back 3000 years, with earliest reports of lip switch procedures more than 2 centuries ago in Europe, when noma was still endemic in Europe, indicating that the anatomy was better understood by the barber surgeons of the past than we like to acknowledge. We are still faced with such challenging cases all over the world where resources are limited. Our current understanding of perforator anatomy and blood supply makes more frequent revisits to flaps of the past with modern advances. Innovative solutions are imperative for salvage, and old ideas tend to reappear when they prove to be useful. Herein, we describe in open access a new reconstructive method where we combined a large lip switch flap together with a composite advancement modiolus flap to reconstruct a whole lower lip and the donor defect of the upper lip all at once, a procedure that is simple to perform and works in settings where it is greatly needed.
下唇完全缺失会使人衰弱，并带来重建挑战。旨在恢复口腔节制功能和外观，成功的重建对个体患者的生活质量有巨大影响。早期用于唇部重建的局部组织重排方法可追溯到3000年前，最早关于唇部转换手术的报道是在2个多世纪前的欧洲，当时坏疽性口炎在欧洲仍然流行，这表明过去的理发师外科医生对解剖结构的理解比我们愿意承认的要好。在世界各地资源有限的情况下，我们仍然面临着这样具有挑战性的病例。我们目前对穿支解剖和血供的理解促使我们借助现代进展更频繁地重新审视过去的皮瓣。创新解决方案对于挽救至关重要，当旧观念被证明有用时往往会再次出现。在此，我们以开放获取的方式描述一种新的重建方法，即我们将一个大型唇部转换皮瓣与一个复合推进蜗轴皮瓣相结合，一次性重建整个下唇以及上唇的供区缺损，该手术操作简单，在急需的情况下可行。
