Reconstruction of Lower Lip Defects aFter Tumor Excision: An Aesthetic and Functional Evaluation

Abstract

We are presenting a new questionnaire to evaluate the functional and aesthetic aspects after reconstruction of defects of the lower lip resulting from tumor excision. The questionnaire is based on objective parameters with numerical values. The application of the questionnaire is carried out based on 2 different surgical techniques, which have been used in the Department of Oral and Maxillofacial Surgery of La Princesa University Hospital in Madrid. These techniques are used in the reconstruction of surgical defects and concern the location and percentage of the lip resection. These techniques are the rotation-advancement flap by Yu and the rotation-advancement in island flap by Colmenero et al. The defects are located laterally and they include 40% to 60% of the length of the lip, avoiding the commissure. There is also one case with a defect that is almost 100% of the length of the lip. According to the questionnaire, we conclude that in unilateral defects that exceed 50% (up to 70%), Yu's technique provides better results from an aesthetic and functional point of view than Colmenero's technique. In subtotal defects, bilateral Yu flaps provide optimum function, with good position of the scars. This is a technique to be considered when confronted with extensive defects of the lip that do not include the commissures.

Meyer?s surgical procedure for the treatment of lip carcinoma

“…Only few functional evaluations with objective parameters have been found in the literature on reconstructive surgery of the lip [13,19], thus allowing no valuable comparison of our results with those of other authors. Three out of 24 patients presented a postoperative hindering microstomy secondary to a postoperative dehiscence in two cases and to an improper use of the technique in one case (tumor size too large to perform a Meyer's plasty).…”

Development and preliminary validation of the Lip Reanimation Outcomes Questionnaire

“…A search for relevant studies revealed 432 studies, of which six met inclusion criteria and had disease-specific items relevant to lip dysfunction (Fig 1). 1,10,14,15,20,21 Further items were generated on the basis of expert opinion. Two subscales, consisting of a 15-item patient rated subscale and a four-item external rater subscale, were created (Fig 2).…”

Reconstruction of the lower lip after broad oncologic resection by Colmenero flap: a reliable option

“…Its compliance with the lines of tension of the lower one-third of the face, the creation of a neo-vermilion and its wide design provide a satisfactory and symmetric esthetic result that is also functional, while avoiding the risk of microstomia. Compared to the Colmenero flap, the Yu flap involves a higher level of technical difficulty and a smaller supply of tissue, but better aesthetic acceptance and equal or greater lip closure 13 . In our experience, the final functional and aesthetic results of the Colmenero flap were satisfactory in all cases, even if half of patients required surgical retouching at a second stage.…”