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新型扇形皮瓣修复下唇大面积缺损

A New Modification of Fan Flap for Large Lower Lip Defects.

机构信息

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.

出版信息

Scand J Surg. 2019 Jun;108(2):172-177. doi: 10.1177/1457496918798211. Epub 2018 Sep 4.

Abstract

BACKGROUND AND AIMS

The reconstruction of the lower lip defects which may result from malignancy, trauma, and burn is necessary for mastication, oral competence, salivary retain, articulation, and aesthetic appearance of the face. While small (30% of the lower lip) and medium (30%-80% of the lower lip) size defects are reconstructed using primary repair and local flaps, reconstruction of the large defects including total and near-total of the lower lip is very challenging entity. We introduce a new modification of the fan flap named extended fan flap for reconstruction of the total and near-total lower lip defects.

MATERIAL AND METHODS

The extended fan flap was used for 12 patients with defects involving more than 80% of the lower lip due to squamous cell carcinoma excision. Most of the patients were males (80.9%) with an average age of 66.8 years (range, 47-82 years).

RESULTS

No major complication is observed in the postoperative period. The functional and aesthetic results were satisfactory. The sphincter function for normal mastication, eating, and salivary retain was reestablished. No microstomy was seen and insertion of artificial dentition was possible for patients.

CONCLUSION

We believe that the unilateral extended fan flap is a reliable and safe option with satisfactory functional and aesthetic results for total and near-total (more than 80%) lower lip defects.

摘要

背景与目的

由于恶性肿瘤、外伤和烧伤导致的下唇缺损需要进行修复,以恢复咀嚼、口腔功能、唾液保留、发音和面部美观。对于小(下唇的 30%)和中(下唇的 30%-80%)度缺损,可以通过一期修复和局部皮瓣进行重建,而对于大(下唇的 80%以上)度缺损,包括全下唇和近全下唇缺损的重建则极具挑战性。我们介绍了一种新的扇形皮瓣改良方法——扩展扇形皮瓣,用于重建全下唇和近全下唇缺损。

材料与方法

我们采用扩展扇形皮瓣对 12 例因鳞状细胞癌切除而导致下唇超过 80%缺损的患者进行了修复。这些患者大多数为男性(80.9%),平均年龄为 66.8 岁(范围为 47-82 岁)。

结果

术后无重大并发症发生。功能和美学效果令人满意。患者的正常咀嚼、进食和唾液保留的括约肌功能得以重建。未出现小口畸形,患者可插入义齿。

结论

我们认为,对于全下唇和近全下唇(超过 80%)缺损,单侧扩展扇形皮瓣是一种可靠且安全的选择,可获得满意的功能和美学效果。

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