Anuj Dadhich1, Seemit Shah1, Kumar Nilesh2, Haish Saluja1, Vijaykuamar Girhe3, Sumit Agarwal4, Madan Mishra5. 1. Department of Oral & Maxillofacial Surgery, Rural Dental College & Hospital, Loni, Maharashtra, India. 2. Department of Oral & Maxillofacial Surgery, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India. 3. Dept. of Oral and Maxillofacial Surgery, Hedgewar Smruti Dental College, Hingoli, Maharashtra, India. 4. Maxillofacial Surgeon, Siliguri, West Bengal, India. 5. Dept. of Oral & Maxillofacial Surgery, Sardar Patel Dental College, Luckhnow, Uttar Pradesh, India.
Abstract
AIM: The purpose of this paper is to describe different acquired conditions necessitating lip reconstruction and present our ten-years' experience in managing the same at a tertiary care hospital. MATERIALS AND METHODS: Data of patients undergoing reconstruction of acquired lip defects from January 2009 to December 2019 were analyzed for demographic details, etiology, extent of defect, reconstruction option used, outcome and complications. RESULTS: 89 patients underwent lip reconstruction after excision of malignant tumors (81%), vascular malformations (12%) and traumatic injuries (7%). Mucosal and cutaneous lip defects were seen in 8 (9%) and 3 (3%) patients respectively, which were treated by primary closure, local advancement flap and tongue flap. Full thickness defects involving less than 1/3rd of lip (36%) and involving up to 2/3rd of lip (33%) were treated by primary closure, Abbe, Abbe Estlander flap and Karapenzic, Bernard Webster & peri-alar crescentic flaps respectively. Sub-total lip defects were repaired using distant and free vascularized flaps. All the localized cutaneous/mucosal defect repair healed uneventfully. Complications associated full thickness defect reconstruction included reduced stoma, flap necrosis and hypertrophic scar. CONCLUSIONS: Repair of localized cutaneous/mucosal defects of lip are simple with no significant documented complication. However, full thickness tissue loss necessities careful surgical planning. The choice of surgical technique depends on the extent of lip length lost. While Karapandzic flap was most commonly utilized to reconstruct lip defect involving up to 2/3rd of the lip, radial forearm flap was a choice in managing subtotal lip tissue loss.
AIM: The purpose of this paper is to describe different acquired conditions necessitating lip reconstruction and present our ten-years' experience in managing the same at a tertiary care hospital. MATERIALS AND METHODS: Data of patients undergoing reconstruction of acquired lip defects from January 2009 to December 2019 were analyzed for demographic details, etiology, extent of defect, reconstruction option used, outcome and complications. RESULTS: 89 patients underwent lip reconstruction after excision of malignant tumors (81%), vascular malformations (12%) and traumatic injuries (7%). Mucosal and cutaneous lip defects were seen in 8 (9%) and 3 (3%) patients respectively, which were treated by primary closure, local advancement flap and tongue flap. Full thickness defects involving less than 1/3rd of lip (36%) and involving up to 2/3rd of lip (33%) were treated by primary closure, Abbe, Abbe Estlander flap and Karapenzic, Bernard Webster & peri-alar crescentic flaps respectively. Sub-total lip defects were repaired using distant and free vascularized flaps. All the localized cutaneous/mucosal defect repair healed uneventfully. Complications associated full thickness defect reconstruction included reduced stoma, flap necrosis and hypertrophic scar. CONCLUSIONS: Repair of localized cutaneous/mucosal defects of lip are simple with no significant documented complication. However, full thickness tissue loss necessities careful surgical planning. The choice of surgical technique depends on the extent of lip length lost. While Karapandzic flap was most commonly utilized to reconstruct lip defect involving up to 2/3rd of the lip, radial forearm flap was a choice in managing subtotal lip tissue loss.