Oral commissure reconstruction with orbicularis oris elastic musculomucosal flaps.

نویسندگان

  • E Robotti
  • B Righi
  • M Carminati
  • L Ortelli
  • P P Bonfirraro
  • L Devalle
  • M A Bocchiotti
چکیده

Surgical reconstruction of the oral commissure aims to restore both symmetry of the lips at rest and, more importantly, full oral competence. Moulding the lip commissure with functional and cosmetic fidelity remains till today a difficult task. A possible surgical solution, the 'elastic flap' principle described by Goldstein, may be found in the wide full-thickness mobilization of the upper and lower vermilion as two composite myocutaneous flaps - tissue sandwiches consisting of labial skin, orbicularis oris muscle and oral mucosa - on the axial pattern of the superior and inferior labial arteries. Based on the contralateral commissure, both flaps are easily 'stretched', accordion-like, to reach the predetermined point of the new commissure, using to full advantage the inherent elastic potential of both vermilions. The fibres of the orbicularis oris muscle at each end of both flaps are embricated to reconstitute a neo-modiolus, which is anchored to the residual buccinator muscle in primary reconstructions, or to the available peri-oral fibrous tissue in secondary procedures. The authors present a select group of 22 patients, who, between 1993 and 2008, underwent this reconstruction procedure for primary or secondary defects involving the oral commissure. The results were generally satisfactory, both functionally and cosmetically. The advantages of this procedure include full restoration of the dynamic function of the orbicularis ring in a single-stage operation and avoidance of either lipswitching procedures or of mobilization of mucosa and cheek skin. The final scars remain well camouflaged within the oral mucosa and the mucocutaneous junction of each lip.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The New Transverse–Facial Artery Musculomucosal Flap for Intraoral Reconstructions

1 BACKGROUND Head/neck cancer resections often require reconstruction to restore form and function. Small-to-medium size intraoral defects can be successfully reconstructed by local pedicled flaps, such as the facial artery musculomucosal (FAMM) flap,1 which encompasses different layers: cheek mucosa and submucosa, the underlying layer of the buccinator muscle, a portion of the orbicularis oris...

متن کامل

Advanced squamous cell carcinoma involving both upper and lower lips and oral commissure with simultaneous reconstruction by local flap: a case report

INTRODUCTION Squamous cell carcinoma is one of the most common malignant tumors of the skin and oral mucosa. However, squamous cell carcinoma involving near total upper and lower lip and oral commissure is rarely seen in the English literature. Simultaneous reconstruction of the upper and lower lips has been inconclusive and presents a challenge to the surgeon. We report such a case and outline...

متن کامل

Vermilion Reconstruction with Genital Mucosa

Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity of...

متن کامل

Transoral Cross-Lip (Abbé-Estlander) Flap as a Viable and Effective Reconstructive Option in Middle Lower Lip Defect Reconstruction

The Abbé-Estlander flap surgery is a cross-lip procedure that is valuable in repairing a defect on the lower lip using a full-thickness flap, consisting of the skin, muscle and mucosa, from the upper lip. As usefulness and practicality of the flap in reconstruction of lower lip surgical defects in Asian ethnicity have not been documented, the authors present a case of successful lower lip recon...

متن کامل

Single-stage reconstruction for buccal mucosa tumor resection including the labial commissure using a facial artery musculomucosal flap and a vermilion advancement flap

Resection of buccal mucosa tumors may occasionally involve the labial angle and peripheral skin. Reconstruction is required when the resection involves more than one-third of the lip. We describe a single-stage reconstruction using a facial artery musculomucosal (FAMM) flap and a vermilion advancement flap after buccal mucosa resection including the labial angle. A 62-year-old woman with carcin...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of plastic, reconstructive & aesthetic surgery : JPRAS

دوره 63 3  شماره 

صفحات  -

تاریخ انتشار 2010