Trøstrup Hannah, Løvenwald Jette B, Hesselfeldt Jørgen
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Int J Surg Case Rep. 2019;58:96-99. doi: 10.1016/j.ijscr.2019.04.014. Epub 2019 Apr 16.
Squamous cell carcinomas are the most common type of lower lip cancer. In cases where the tumour involves less than on third of the lower lip, direct suture maintains the physical appearance of a normal mouth with few adverse effects. Squamous cell carcinomas involving more than half or even most of the lower lip are not common. We report a successful case of complete lower lip reconstruction after recurrent squamous cell carcinoma involving most of the lower lip by use of bilateral Fujimori technique.
We present a case of full-thickness squamous cell cancer located to the vermillion border initially, but progressing rapidly in two months during radiotherapy to a state in which most of the lower lip, including the angles of the mouth, were affected.
Surgical management ensuring a functional and aesthetic acceptable outcome is a challenge in patients with large tumours including all of the lower lip. Several methods for reconstruction of the entire lower lip are discussed.
Bilateral Fujimori one-stage flaps can be used in cases of squamous cell carcinomas involving most of the lower lip, including the commissures of the mouth. A limitation of the method is an eventual lack of local tissue when preparing the flap.
鳞状细胞癌是下唇癌最常见的类型。在肿瘤累及不到三分之一下唇的病例中,直接缝合可保持正常口腔的外观,且不良反应较少。累及超过一半甚至大部分下唇的鳞状细胞癌并不常见。我们报告了一例通过使用双侧藤森技术成功重建下唇的病例,该病例为复发性鳞状细胞癌累及大部分下唇。
我们呈现一例全层鳞状细胞癌病例,最初位于唇红缘,但在放疗的两个月期间迅速进展,达到下唇大部分包括口角均受影响的状态。
对于包括整个下唇在内的大肿瘤患者,确保功能和美学上可接受的结果的手术管理是一项挑战。讨论了几种重建整个下唇的方法。
双侧藤森一期皮瓣可用于累及大部分下唇包括口角的鳞状细胞癌病例。该方法的一个局限性是在制备皮瓣时最终可能缺乏局部组织。