RECONSTRUCTION OF TOTAL LIP DEFECT BY MEANS OF COMPOSITE FASCIOCUTANEOS FREE FLAP

González Ballester David1, Rubio Correa Isidoro1, Hernández Vila Cristina1, Moreno Sánchez Manuel1, Ruiz Laza Luis1, Manzano Sólo de Zaldívar Damián1, González García Raúl1 Monje Gil Florencio1. 1Department of Oral and Maxillofacial Surgery, University Hospital Infanta Cristina. Badajoz, Spain.

Introduction: REconstruction of labial defects constitutes an authentic challenge for reconstructive surgeons. Functional and aesthetic considerations are equally important for a success final outcome. Diferrent reconstructive techniques ca be used for restoring perioral region such as local flaps, regional flaps and microvascularized free flaps. In case of absence of oral compentence,a composite fascicuotaneus free flap including palmalis longus tendon alllows to achieve a normal labial function with a favorable result.

Case 1 - lower lip

Purpose: To show our experience in the reconstruction of total lip defects by means of composite fasciocutaneous – palmaris longus tendon free flap

Materials and Methods: Three men with a mean age of 66.33 years (range: 54-73) were diagnosed with squamous cell carcinomaof the lip region (2 of the lower lip and 1 of the upper lip). Sixty six percent of patients received radiotherapy as the first choice of treatment, being necessary subsequent surgery for recurrent disease. All patients were reconstructed using the composite radial forearm – palmaris longus tendon free flap. In all cases, the tendon of palmaris longus wasanastomosed to the orbicularis oris muscle.

Results: At a mean follow-up of two years (range: 1 to 3) no signs of locoregional recurrence were observed. A good aesthetic and functional result were obtained in all patients, achieving an excellent lip competence. No postoperative complications were perceived. All patients were satisfied with their final reconstructive result.

Conclusions: Lip reconstruction is a challenge for the head and neck surgeon. In situations where large defects are originated after wide resections, reconstruction with composite microvascular flaps constitutes an excellent option.

Case 2 - upper lip