DOI QR코드

DOI QR Code

Effective method for reconstruction of remaining lower lip vermilion defect after a mental V-Y advancement flap

  • Kim, Joo-Hak (Department of Plastic and Reconstructive Surgery, School of Medicine, Chungnam National University) ;
  • Ahn, Chang Hwan (Department of Plastic and Reconstructive Surgery, School of Medicine, Chungnam National University) ;
  • Kim, Sunje (Department of Plastic and Reconstructive Surgery, School of Medicine, Chungnam National University) ;
  • Lee, Won Suk (Department of Emergency Medicine, Eulji University College of Medicine) ;
  • Oh, Sang-Ha (Department of Plastic and Reconstructive Surgery, School of Medicine, Chungnam National University)
  • 투고 : 2018.06.25
  • 심사 : 2019.04.02
  • 발행 : 2019.04.20

초록

Background: The mental V-Y advancement flap method is useful for reconstruction of lower lip defect because of its many advantages. However, it is not easy to select the optimal reconstructive method for the vermilion defect that remains after application of the mental V-Y advancement flap. In choosing the representative surgical method for vermilion mucosal reconstruction including mucosal V-Y advancement flap, buccal mucosal flap, and buccal mucosal graft. We describe an efficient technique to large lower lip defects combining mental V-Y advancement flap and buccal mucosal graft Methods: This study included 16 patients who underwent reconstructive surgery for full-thickness and large defect (> half the entire width) of the lower lip from October 2006 to September 2017. The operation was conducted using mental V-Y advancement flap with various vermilion mucosal reconstruction methods considering the location of the defect and the amount of residual tissue of the lip coloboma after excision. Results: All patients underwent mental V-Y advancement flap. In vermilion mucosal reconstruction, five patients underwent mucosal V-Y advancement flap, three underwent buccal mucosal flap, and eight underwent buccal mucosal graft. There were good aesthetic and functional results in all patients who underwent buccal mucosal graft. However, two patients who underwent mucosal V-Y advancement flap complained of oral incompetence, and all patients who underwent buccal mucosal flap had oral commissure deformity. Conclusion: Buccal mucosal graft combined with mental V-Y advancement flap can produce suitable functional and aesthetic outcomes in near total lower lip reconstruction in patient with large mucosal defect including vermilion portion.

키워드

참고문헌

  1. Closmann JJ, Pogrel MA, Schmidt BL. Reconstruction of perioral defects following resection for oral squamous cell carcinoma. J Oral Maxillofac Surg 2006;64:367-74. https://doi.org/10.1016/j.joms.2005.11.025
  2. Bayramicli M, Numanoglu A, Tezel E. The mental V-Y island advancement flap in functional lower lip reconstruction. Plast Reconstr Surg 1997;100:1682-90. https://doi.org/10.1097/00006534-199712000-00006
  3. Chen WL, Wang YY, Zhou M, Yang ZH, Zhang DM. Double mental neurovascular V-Y island advancement flaps combined with tongue flaps for functionally reconstructing total lowerlip defects. J Craniofac Surg 2012;23:181-3. https://doi.org/10.1097/SCS.0b013e3182418ed5
  4. Jin X, Teng L, Zhang C, Xu J, Lu J, Zhang B, et al. Reconstruction of partial-thickness vermilion defects with a mucosal V-Y advancement flap based on the orbicularis oris muscle. J Plast Reconstr Aesthet Surg 2011;64:472-6. https://doi.org/10.1016/j.bjps.2010.07.017
  5. Ono I, Gunji H, Tateshita T, Sanbe N. Reconstruction of defects of the entire vermilion with a buccal musculomucosal flap following resection of malignant tumors of the lower lip. Plast Reconstr Surg 1997;100:422-30. https://doi.org/10.1097/00006534-199708000-00024
  6. Seo YJ, Song SH, Choi YW, Oh SH. A lower lip reconstruction. Dermatol Surg 2015;41:505-7. https://doi.org/10.1097/DSS.0000000000000332
  7. Jun G, Wei F, Tong L, Yi H, Hao Z, Jun LS. Aesthetic and functional evaluation of large full-thickness vermilion and lower lip defects reconstruction. J Craniofac Surg 2019;30:e36-9. https://doi.org/10.1097/SCS.0000000000004952
  8. Erol OO, Pence M, Agaoglu G. The Abbe island flap for the reconstruction of severe secondary cleft lip deformities. J Craniofac Surg 2007;18:766-72. https://doi.org/10.1097/scs.0b013e318068438b
  9. Karapandzic M. Reconstruction of lip defects by local arterial flaps. Br J Plast Surg 1974;27:93-7. https://doi.org/10.1016/0007-1226(74)90068-X
  10. Webster RC, Coffey RJ, Kelleher RE. Total and partial reconstruction of the lower lip with innervated musclebearing flaps. Plast Reconstr Surg Transplant Bull 1960;25:360-71. https://doi.org/10.1097/00006534-196004000-00007
  11. Alic B, Gurel M, Cilengir M, Seyhan A, Atlihan S. Unilateral gate flap for reconstruction of the lower lip. Plast Reconstr Surg 1989;84:814-9. https://doi.org/10.1097/00006534-198911000-00018
  12. Stranc MF, Robertson GA. Steeple flap reconstruction of the lower lip. Ann Plast Surg 1983;10:4-11. https://doi.org/10.1097/00000637-198301000-00002
  13. Kawamoto HK Jr. Correction of major defects of the vermilion with a cross-lip vermilion flap. Plast Reconstr Surg 1979;64:315-8. https://doi.org/10.1097/00006534-197909000-00005
  14. Yano K, Hosokawa K, Kubo T. Combined tongue flap and V-Y advancement flap for lower lip defects. Br J Plast Surg 2005;58:258-62. https://doi.org/10.1016/j.bjps.2004.10.021
  15. Goldstein MH. A tissue-expanding vermilion myocutaneous flap for lip repair. Plast Reconstr Surg 1984;73:768-70. https://doi.org/10.1097/00006534-198405000-00008
  16. Sand M, Altmeyer P, Bechara FG. Mucosal advancement flap versus primary closure after vermilionectomy of the lower lip. Dermatol Surg 2010;36:1987-92. https://doi.org/10.1111/j.1524-4725.2010.01762.x
  17. Vecchione TR. Palatal grafts for lip reconstruction. Ann Plast Surg 1983;10:301-5. https://doi.org/10.1097/00000637-198304000-00007
  18. Ito R, Fujiwara M. Lower lip reconstruction with a hard palate mucoperiosteal graft. J Plast Reconstr Aesthet Surg 2009;62:e333-6. https://doi.org/10.1016/j.bjps.2007.12.052