Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (9): 577-581.doi: 10.12016/j.issn.2096-1456.2019.09.006

• Prevention and Treatment Practice • Previous Articles     Next Articles

Application of a modified M-shaped flap in defect repair after resection of lower lip cancer

CHEN Junwen1,XU Qian2,LIU Kun1,GAO Peng1,LI Jun2()   

  1. 1.Xinjiang Medical University, Urumchi 830000, China
    2.Department of Oral and Maxillofacial Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumchi 830000, China
  • Received:2019-01-24 Revised:2019-04-10 Online:2019-09-20 Published:2019-09-20
  • Contact: Jun LI E-mail:kqlj2008@aliyun.com

Abstract:

Objective To observe the clinical effect of the modified M-shaped flap for repairing defects following resection of lower lip cancer and to provide a reference for clinical application.Methods Fourteen cases using modified M-shaped flaps to repair lower lip cancer surgery defects were retrospectively analyzed. The postoperative follow-up patients’ flap survival, mouth opening, denture use, bilateral mouth angle symmetry, recurrence and survival were analyzed.Results Fourteen patients with lower lip cancer underwent reconstruction immediately after surgery, and the defect range after tumor resection was 30% to 50% of the lower lip. The continuity of the orbicularis oculi muscle is reconstructed by modified M-shaped flap to transfer bilateral residual lip tissue. The blood supply to the flap is stable. All patients’ flaps survived completely without complications, such as hemorrhage, infection or flap necrosis, and their lip movement and sensation recovered well. There were no obvious obstacles in opening and closing or pronunciation and dietary function, and the mean maximum opening was (3.06 ± 0.23) cm. Three patients used active dentures, which could be removed normally. All patients’mouths were preserved. Approximately 85.7% of patients (12/14) had bilateral symmetry of the bilateral mouth, the flaps matched the facial color, and the lower lip was naturally beautiful, as the scar was not obvious. After 6 months to 4 years of follow-up (mean 2 years and 6 months), no recurrence or death occurred.Conclusion The modified M-shaped valve design is simple and easy to operate. This method can be applied to 30% to 50% defect reconstructions of the lower lip to retain the corner of the mouth.

Key words: modified M-shaped flap, lower lip cancer, defect repair, flap, pedicle flap, sliding flap, orbicularis oris muscle

Table 1

Defect range, and functional recovery data from 14 patients"


年龄
(岁)
临床
分期
病理诊断 缺损
范围
(%)
随访
时间
(月)
术后最大
开口度
(cm)
术后口
角对称
情况
50 T1期 鳞状细胞癌 30 24 3.5 基本对称
54 T1期 鳞状细胞癌 32 36 3.4 不对称
66 T1期 鳞状细胞癌 40 36 3.2 基本对称
80 T1期 鳞状细胞癌 45 48 3.0 基本对称
74 T1期 鳞状细胞癌 42 12 3.1 基本对称
75 T2期 鳞状细胞癌 50 36 2.9 基本对称
68 T1期 鳞状细胞癌 46 48 3.0 基本对称
63 T1期 鳞状细胞癌 38 12 3.2 基本对称
57 T1期 鳞状细胞癌 50 36 2.7 基本对称
49 T1期 鳞状细胞癌 45 24 3.0 基本对称
78 T2期 鳞状细胞癌 50 6 2.8 基本对称
59 T1期 鳞状细胞癌 50 48 2.8 基本对称
63 T1期 疣状癌 38 24 3.2 不对称
66 T1期 鳞状细胞癌 42 36 3.1 基本对称

Figure 1

Application of the modified M-shaped flap to repair postoperative defect of lower lip cancer"

[1] 丁旭宣, 吴俊伟, 彭国光 . Abbe瓣修复上唇缺损的临床观察[J]. 广东牙病防治, 2009,17(10):489-491.
[2] 李喆, 刘林奇, 王凡 , 等. 改良斧形肌肉粘膜瓣修复半侧红唇缺损的回顾性分析[J]. 中国美容医学, 2016,25(2):17-20.
[3] Imura H, Furukawa H, Sakuma C , et al. Reconstruction after resection of carcinoma of the lower lip[J]. Br J Oral Maxillofac Surg, 2018,56(2):153-154.
[4] Mu EW . The transposition flap for the reconstruction of lower cutaneous lip defects[J]. J Drugs Dermatol, 2017,16(4):385-387.
[5] Gupta B, Johnson NW . Global epidemiology of head and neck cancers: a continuing challenge[J]. Oncology, 2016,91(1):13-23.
[6] Biasoli ÉR, Valente VB, Mantovan B , et al. Lip cancer: a clinicopathological study and treatment outcomes in a 25-year experience[J]. J Oral Maxillofac Surg, 2016,74(7):1360-1367.
[7] Harris L, Higgins K . Local flap reconstruction of acquired lip defects[J]. Curr Opin Otolaryngol Head Neck Surg, 2012,20(4):254-261.
[8] Ogino A, Onishi K, Okada E . Unit advancement flap for lower lip reconstruction[J]. J Craniofac Surg, 2018,29(3):668-670.
[9] Lubek JE . Lip reconstruction[J]. Oral Maxillofac Surg Clin North Am, 2013,25(2):203-214.
[10] Bektas G, Cinpolat A, Biçici P , et al. Reconstruction of lateral lower lip defects with transverse lip advancement flap[J]. J Craniofac Surg, 2013,24(3):984-986.
[11] Ebrahimi A, Maghsoudnia GR . Prospective comparative study of lower lip defects reconstruction with different local flaps[J]. J Craniofac Surg, 2011,22(6):2255-2259.
[12] Fujiwara T, Chen CC, Shih HS , et al. Stair-step flap for secondary lower lip revision after lip and cheek composite defects reconstruction[J]. Head Neck, 2011,33(9):1322-1327.
[13] Husein-EI, Ahmed H . Lower lip reconstruction using a skin-mucosa Abbe-Estlander flap after squamous cell carcinoma excision[J]. An Bras Dermatol, 2017,92(2):260-262.
[14] Kumar A, Shetty PM, Bhambar RS , et al. Versatility of abbe-estlander flap in lip reconstruction--a prospective clinical study[J]. J Clin Diagn Res, 2014,8(10):18-21.
[15] Griffin GR, Weber S . Outcomes following V-Y advancement flap reconstruction of large upper lip defects[J]. Arch Facial Plast Surg, 2012,14(3):193-197.
[16] Zeitouni NC, Ang JM, Weyer CW . Horizontally opposed V-Y advancement flaps for surgical reconstruction of central upper lip defects[J]. J Craniofac Surg, 2017,28(2):578-579.
[17] Matteini C, Mazzone N, Rendine G . Lip reconstruction with local M-shaped composite flap[J]. J Craniofac Surg, 2010,21(1):225-228.
[18] Elmelegy N . One stage aesthetic and functional reconstruction of major lower lip defects[J]. Ann Plast Surg, 2017,78(4):417-420.
[19] Gonzalez A . Reconstruction of large defects of the lower lip after mohs surgery: the use of combined karapandzic and Abbe flaps[J]. Ann Plast Surg, 2018,81(4):433-437.
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