Department of Otolaryngology Head and Neck Surgery, University of Washington, WA, US.
Curr Opin Otolaryngol Head Neck Surg. 2023 Dec 1;31(6):441-451. doi: 10.1097/MOO.0000000000000926. Epub 2023 Oct 12.
This review describes the fundamental principles and recent advances in the reconstruction of total lower lip defects to restore peri-oral aesthetic and function.
Modifications to the Abbe flap and visor flap have recently been described. Recent advances to free flap techniques have focused on dynamic restoration of lower lip sling function after reconstruction. This involves the transfer of innervated or noninnervated muscle tissue to reconstruct the lower lip to restore the sphincter function of the lips.
The reconstructive goals for a full thickness lower lip defect are to restore a functional oral sphincter, replace mucosal and external skin, and maintain a functional size of the oral aperture. Local flap reconstruction of sub-total lower lip defects is possible, but use of local flaps for total lip reconstruction often leads to microstomia. Several static and dynamic free tissue transfer options exist for lower lip reconstruction and have been summarized in this review.
本文描述了全下唇缺损重建以恢复口周美学和功能的基本原则和最新进展。
最近描述了 Abbé 皮瓣和遮阳板皮瓣的改良。游离皮瓣技术的最新进展集中在下唇吊带功能的动态重建上，包括在重建后转移神经支配或非神经支配的肌肉组织来重建下唇，以恢复唇的括约肌功能。
全层下唇缺损的重建目标是恢复功能性口腔括约肌，替换黏膜和外部皮肤，并保持口腔开口的功能性大小。对于下唇部分缺损，可进行局部皮瓣重建，但对于全唇缺损，常采用局部皮瓣重建，导致小口畸形。本文总结了几种用于下唇重建的静态和动态游离组织转移方法。
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