Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, Oral Diseases Laboratory of Liaoning, China Medical University, Shenyang, Liaoning, China.
Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China.
Head Neck. 2023 Jun;45(6):1511-1518. doi: 10.1002/hed.27364. Epub 2023 Apr 4.
Lower lip reconstruction aims to maintain facial subunit function and aesthetics. We present a minor modification of the McGregor flap technique, in which depressor anguli oris (DAO) muscle is separately elevated as a chimeric flap together to investigate the outcomes for reconstructing lower lip defects using various functional parameters.
The study included patients who underwent surgical repair of lower lip defects using a McGregor fan flap with or without DAO muscle chimeric flap between January 2018 and May 2021. The patients were divided into our modified technique with DAO chimeric flap (study group) and conventional McGregor (control group). The primary outcomes were functional evaluation of oral competency, speech intelligibility, and tactile sensation of reconstructed lip outcomes. The functional satisfaction and Patient and Observer Scar Assessment Scale (POSAS) were analyzed.
A total of 20 patients were enrolled (10 patients for each group). Excellent oral competence was present in 12 patients, favorably significant in patients with DAO chimeric flap (n = 8/10, p = 0.018). All patients had intelligible speech with insignificant differences between the two groups. No patients demonstrated differences to light touch from baseline sensation at 1 year. Patients in the study group reported more lip function satisfaction (p = 0.049). The POSAS score indicates satisfaction with the appearance of all patients.
McGregor fan technique combined with DAO muscle chimeric flap offers a good choice by maintaining sensory and motor functions. Our minor modification can ensure the integrity of the oral sphincter, leading to improved lower lip function.
下唇重建旨在维持面部分区功能和美学。我们提出了 McGregor 皮瓣技术的一个小改进，其中降口角肌（DAO）被单独提升为嵌合瓣，以使用各种功能参数研究重建下唇缺损的结果。
本研究纳入了 2018 年 1 月至 2021 年 5 月期间接受 McGregor 扇形皮瓣修复下唇缺损的患者，其中部分患者联合使用或不使用 DAO 肌嵌合瓣。患者分为我们的改良技术加 DAO 嵌合瓣（研究组）和传统 McGregor（对照组）。主要结果是对口颌功能、语音清晰度和再造唇的触觉感知进行功能评估。对功能满意度和患者和观察者瘢痕评估量表（POSAS）进行了分析。
共纳入 20 例患者（每组 10 例）。12 例患者具有良好的口腔功能，DAO 嵌合瓣组患者明显更优（n=8/10，p=0.018）。所有患者的语音均清晰可辨，两组间无显著差异。所有患者在 1 年时对轻触的感觉与基线无差异。研究组患者的唇部功能满意度更高（p=0.049）。POSAS 评分显示所有患者对外观均满意。
McGregor 扇形皮瓣技术联合 DAO 肌嵌合瓣可以维持感觉和运动功能，是一种较好的选择。我们的小改进可以确保口腔括约肌的完整性，从而改善下唇功能。
