George Rinku, Rajan Jyotsna, Neralla Mahathi, Kumar Santhosh P, Haque Ahmed Elham
Oncology, Oral Cancer Institute, Saveetha Dental College, Chennai, IND.
Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Chennai, IND.
Cureus. 2019 Oct 18;11(10):e5942. doi: 10.7759/cureus.5942.
Many reconstruction methods are performed for combined defects of upper lip and premaxilla in oral cancer patients, which are complicated and multiple staged procedures, compromising the functional or structural unit. In this case report, we present a modification of the bilateral perialar crescent flap for reconstructing the combined defect of upper lip and premaxilla in a single stage. A patient diagnosed with well-differentiated squamous cell carcinoma of premaxilla and upper lip, involving a surgical defect of more than one-third but less than two-thirds of the lip underwent two cycles of neoadjuvant chemotherapy. Later wide local excision of the lesion and simultaneous reconstruction with a modified perialar crescent flap was performed in a single stage. Patient recovered uneventfully and tolerated the procedure well, without any complications. The patient was found to be satisfied with the functional and esthetic result. The reduced upper lip support which was a result of the bony defect of the premaxilla, was corrected with a dental prosthesis. This modification is a useful reconstruction tool for oral cancer patients with combined defects of upper lip and premaxilla.
对于口腔癌患者的上唇和前颌骨联合缺损，人们实施了多种重建方法，这些方法复杂且需多阶段进行，会损害功能或结构单元。在本病例报告中，我们介绍了一种改良的双侧眶周新月形皮瓣，用于一期重建上唇和前颌骨联合缺损。一名被诊断为前颌骨和上唇高分化鳞状细胞癌的患者，唇部手术缺损超过三分之一但少于三分之二，接受了两个周期的新辅助化疗。随后，在一期手术中对病变进行了广泛局部切除，并同时用改良的眶周新月形皮瓣进行重建。患者恢复顺利，对手术耐受性良好，未出现任何并发症。患者对功能和美学效果感到满意。因前颌骨骨缺损导致的上唇支撑力下降，通过义齿得到了纠正。这种改良方法是治疗上唇和前颌骨联合缺损的口腔癌患者的一种有用的重建工具。
