Department of Maxillofacial Surgery, Division of Plastic and Reconstructive Surgery of the Head and neck, University Clinical Hospital Dubrava, Avenija Gojka Suska 6, 10000 Zagreb, Croatia.
Department of Plastic and Reconstructive Surgery, The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, Manchester, United Kingdom.
J Plast Reconstr Aesthet Surg. 2019 Mar;72(3):484-490. doi: 10.1016/j.bjps.2018.11.005. Epub 2018 Nov 22.
Lower lip reconstruction remains a challenging task due to multi-functional and high aesthetic requirements that have to be achieved for successful outcome. This is particularly true to near-total lower lip defects, encompassing over 70% of lower lip loss due to cancer, trauma or burns. Despite the fact that numerous flaps and their modifications have been described over the past century, only a few valuable techniques and concepts withstood the test of time for sub-total lower lip defects, each having their own drawbacks. We describe a new approach to these defects combining bilateral Karapandzic and Abbe/Estlander/Stein flaps, not reported so far, and present our long term outcomes.
From 2012 to 2016, five patients with T4 lower lip squamous cell carcinoma (SCC) underwent near-total and total lower lip resection and reconstruction with a combination of bilateral Karapandzic flap and double Abbé/Estlander/Stein flaps from the upper lip.
Our patients were between 44 and 88 years old (mean 66.6). All flaps healed uneventfully in all patients. Patients were followed up between 18 and 60 months (mean follow up 33.6 months). There were no local tumor recurrencies. All patients were able to eat perorally whilst reconstructed lips were fully functional. No drooling was observed and aesthetic outcomes were excellent.
Combined bilateral Karapandzic and Abbe/Estlander/Stein flaps can produce excellent functional and aesthetic outcomes in near total and total lower lip reconstructions and should be considered a reliable reconstructive option in patients with more then 70% of lower lip loss.
由于需要实现成功的结果，下唇重建仍然是一项具有挑战性的任务，因为它具有多功能和高美学要求。对于近全下唇缺损，由于癌症、创伤或烧伤导致下唇丧失超过 70%，情况尤其如此。尽管在过去的一个世纪中已经描述了许多皮瓣及其改良方法，但只有少数有价值的技术和概念经受住了亚全下唇缺损的时间考验，每种方法都有其自身的缺点。我们描述了一种新的方法来处理这些缺陷，结合双侧 Karapandzic 皮瓣和 Abbe/Estlander/Stein 皮瓣，目前尚未报道，并介绍了我们的长期结果。
从 2012 年到 2016 年，5 名 T4 下唇鳞状细胞癌（SCC）患者接受了近全和全下唇切除术和重建，采用双侧 Karapandzic 皮瓣和来自上唇的双 Abbé/Estlander/Stein 皮瓣联合。
我们的患者年龄在 44 至 88 岁之间（平均 66.6 岁）。所有患者的皮瓣均愈合良好。患者随访时间为 18 至 60 个月（平均随访 33.6 个月）。无局部肿瘤复发。所有患者均能经口进食，重建后的嘴唇功能完全正常。未观察到流涎，并且美学效果非常好。
双侧 Karapandzic 皮瓣和 Abbe/Estlander/Stein 皮瓣联合可在近全和全下唇重建中产生出色的功能和美学效果，对于下唇丧失超过 70%的患者，应考虑将其作为一种可靠的重建选择。
