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Functional Reconstruction Using a Depressor Anguli Oris Musculocutaneous Flap for Large Lower Lip Defects, Especially for Elderly Patients

1999; Lippincott Williams & Wilkins; Volume: 103; Issue: 3 Linguagem: Inglês

10.1097/00006534-199903000-00011

1529-4242

Takatoshi Yotsuyanagi, Yoshihiro Nihei, Katsunori Yokoi, Yukimasa Sawada,

Facial Nerve Paralysis Treatment and Research

Described here is a new technique to reconstruct large lower lip defects using one or two musculocutaneous island flaps, which includes an innervated depressor anguli oris muscle and has a facial artery in its pedicle. Vermilion is simultaneously reconstructed using a mucosal transposition flap. Three patients who had a total lower lip defect and five patients who had a defect larger than one-half of the lower lip were treated by our procedure. All the flaps survived completely without any signs of vascular stasis. In six patients, sphincter function and sensation appeared within 3 months after surgery. In one patient who needed a total lower lip reconstruction, the depressor anguli oris muscle was atrophic and the motor nerve could not be found. This patient could not regain motion. One other patient complained of a sialorrhea accompanied by sensory loss; however, his sensation improved within 6 months after surgery. All of the reconstructed lower lips were large enough to enable the patient to wear dentures and were of a cosmetically acceptable appearance 1 year after surgery.