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双层双瓣新组合技术在唇部重建中的应用：病例系列

Lip Reconstruction by Double Layer and Double Flap New Combination Technique: A Case Series.

作者信息

Cortese Antonio, Catalano Salvatore, Giunta Antonio Alberto Maria, Borri Antonio, Panetta Daniele, Claudio Pier Paolo

机构信息

Unit of Maxillofacial Surgery, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy.

ENT Department, Santa Maria della Misericordia Hospital, 06121 Perugia, Italy.

出版信息

Dent J (Basel). 2022 Jan 27;10(2):19. doi: 10.3390/dj10020019.

DOI:10.3390/dj10020019
PMID:35200244
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8870704/
Abstract

In the past, lip reconstruction after ablative surgery has been performed by primary closure and more recently by free flap transfer technique. Cheek's skin flap has been used to reconstruct the lower lip cutaneous portion. This study presents a reconstructive method for the vermillion and the lip's cutaneous portion using the Goldstein-Robotti techniques (for the vermillion) and the buccinator flap to reconstruct the cutaneous lip portion and the perioral muscles. This procedure allows a complete reconstruction with a double layer technique for defects of more than one-third of both lips, together or alone, including modiolus, showing satisfactory functionality and aesthetics. The procedure was carried out by splitting the buccinator muscle and elongating the upper and lower buccinator bundles, together or alone. Soft tissue blunt dissection prevented most facial nerves and vessels injuries, ensuring blood supply and an amount of lip sensitivity. Even in the case of facial vessel ligatures after neck dissection, the technique was possible basing the flap pedicle on the internal maxillary artery branches (buccinator) and contralateral facial vessels (orbicularis). We present a case series of six reconstructions of various defects of the upper and lower lips, including the commissure after ablative surgery for squamous cell carcinoma and polymorphous adenocarcinoma. The results showed satisfactory functional and aesthetic outcomes, with similar tissue texture, static and dynamic symmetry achieved for all the patients.

摘要

过去，消融手术后的唇部重建采用一期缝合，最近则采用游离皮瓣转移技术。颊部皮瓣已被用于重建下唇皮肤部分。本研究提出了一种使用戈尔茨坦 - 罗博蒂技术（用于唇红部）和颊肌瓣重建唇部皮肤部分及口周肌肉的重建方法。该手术采用双层技术，可对双唇超过三分之一的联合或单独缺损，包括口角进行完全重建，功能和美观效果令人满意。手术通过劈开颊肌并延长上、下颊肌束联合或单独进行。软组织钝性分离可防止大多数面神经和血管损伤，确保血供和一定程度的唇部感觉。即使在颈部清扫术后结扎面部血管的情况下，该技术仍可行，皮瓣蒂部基于上颌内动脉分支（颊肌）和对侧面部血管（口轮匝肌）。我们展示了一组6例上、下唇各种缺损重建的病例系列，包括鳞状细胞癌和多形性腺瘤消融手术后的口角缺损。结果显示功能和美观效果令人满意，所有患者均实现了相似的组织质地、静态和动态对称性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/f653ba1bf545/dentistry-10-00019-g016.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/464c63744aee/dentistry-10-00019-g0A1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/873e7e8ab77a/dentistry-10-00019-g010.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/7b5429b62afd/dentistry-10-00019-g014.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/5c45961413b1/dentistry-10-00019-g015.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/f653ba1bf545/dentistry-10-00019-g016.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/464c63744aee/dentistry-10-00019-g0A1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/9bd334d9fa13/dentistry-10-00019-g0A2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/a07bd64c7c7f/dentistry-10-00019-g0A3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/76ddab9b66fd/dentistry-10-00019-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/628e47ff5923/dentistry-10-00019-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/25a4c1898229/dentistry-10-00019-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/3848fbc6d1d2/dentistry-10-00019-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/4919b0cd75c5/dentistry-10-00019-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/225013a7d67e/dentistry-10-00019-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/cf8f6772c2a7/dentistry-10-00019-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/8b63aa885b55/dentistry-10-00019-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/e443ec81ddb4/dentistry-10-00019-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/873e7e8ab77a/dentistry-10-00019-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/fc98fa07ff58/dentistry-10-00019-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/c86c53ab5936/dentistry-10-00019-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/84aecf2f7078/dentistry-10-00019-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/7b5429b62afd/dentistry-10-00019-g014.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/5c45961413b1/dentistry-10-00019-g015.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7915/8870704/f653ba1bf545/dentistry-10-00019-g016.jpg

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