Celal Bayar University Department of Plastic, Reconstructive and Aesthetic Surgery, Manisa, Turkey.
Baskent University Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey.
Microsurgery. 2021 Mar;41(3):216-222. doi: 10.1002/micr.30681. Epub 2020 Nov 10.
Lower lip is a vital organ with important functions as well as aesthetic importance. It is critical to provide an aesthetically appealing lower facial subunit with maintenance of understandable speech and oral competence. Achieving these targets is very difficult especially in total lower lip defects. This report presents a technique using super-thin anterolateral thigh (ALT) flaps with fascia graft for reconstruction of large, complex oral sphincter defects.
Six patients with squamous cell carcinoma (SCC) and one patient with a gunshot injury were presented in this report. All of them had full-thickness defects including skin, orbicularis muscle and oral mucosa. The mean age was 58 (range, 32-85) years. Defects of the lower lip were reconstructed with a super-thin ALT flap. Super-thin flaps were obtained by planning as close to the knee as possible and elevating at the level of superficial fascia. The fascia graft was used for achieving lip suspension.
Overall flap survival was 100%. The flap size ranged from 8 × 6 cm to 14 × 10 cm. The follow-up periods ranged from 6 to 14 months. All the patients achieved acceptable oral competence, both in the resting condition and during speaking and eating, except for one patient who had a drooping lower lip developed in the post-operative 3rd month and underwent a secondary tightening procedure. Another patient needed liposuction due to bulky appearance.
Super-thin ALT flaps seem to be a useful option for functional and aesthetic reconstruction of extensive lip defects.
下唇是一个重要的器官，具有重要的功能和美学意义。提供一个具有吸引力的下唇亚单位，同时保持可理解的言语和口腔功能是至关重要的。实现这些目标非常困难，尤其是在下唇全层缺损的情况下。本报告介绍了一种使用超薄股前外侧（ALT）皮瓣加筋膜移植物修复大面积、复杂口腔括约肌缺损的技术。
本报告介绍了 6 例鳞状细胞癌（SCC）和 1 例枪伤患者。所有患者均有全层缺损，包括皮肤、口轮匝肌和口腔黏膜。平均年龄为 58 岁（范围 32-85 岁）。采用超薄 ALT 皮瓣修复下唇缺损。超薄皮瓣通过尽可能靠近膝关节进行规划，并在浅筋膜平面提起。筋膜移植物用于实现唇悬吊。
总的皮瓣存活率为 100%。皮瓣大小从 8×6cm 到 14×10cm 不等。随访时间从 6 到 14 个月不等。所有患者均获得了可接受的口腔功能，无论是在休息状态还是在说话和进食时，除了 1 例患者在术后第 3 个月出现下唇下垂，需要进行二次收紧手术，另 1 例患者因外观肥大需要吸脂。
超薄 ALT 皮瓣似乎是修复广泛唇缺损的一种有用的选择，可实现功能和美学重建。
