Total Lip Reconstruction with Tendinofasciocutaneous Radial Forearm Flap

Abstract

Introduction. Squamous cell carcinoma is a common tumour of lower lip. Small defects created by surgical resection may be readily reconstructed by linear closure or with local flaps. However, large tumours resection often results with microstomia and oral incompetence, drooling, and speech incomprehension. The goal of this study is to describe our experience with composite free radial forearm-palmaris longus tendon flap for total or near total lower lip reconstruction. Patients and Methods. This procedure was used in 5 patients with 80–100% lip defect resulting from Squamous cell carcinoma. Patients' age ranged from 46 to 82 years. They are three male patients and two female. In 3 cases chin skin was reconstructed as well and in one case a 5 cm segment of mandible was reconstructed using radius bone. In one case where palmaris longus was missing hemi-flexor carpi radialis tendon was used instead. All patients tolerated the procedure well. Results. All flaps totally survived. No patient suffered from drooling. All patients regained normal diet and normal speech. Cosmetic result was fair to good in all patients accept one. Conclusion. We conclude that tendino-fasciocutaneous radial forearm flap for total lower lip reconstruction is safe. Functional and aesthetic result approaches reconstructive goals.

Barrel-shaped design of the forearm free flap for lower lip reconstruction: a pilot case-control study

“…However, more cases and data must be collected to approve this finding in the future. To reconstruct a dynamic sphincter, several suspension procedures using the free forearm flap have been reported in the literature [2][3][4][5][6]. Sakai et al [2] described the use of the palmaris longus tendon with a free forearm flap for full-thickness defects of the lower lip.…”

“…To reconstruct a dynamic sphincter, several methods of suspension procedures using the tendo-fasciocutaneous flap have been described in the literature [3]. The method first described by Sakai et al [2] has been used and modified by other researchers [4][5][6]..…”

Basics of Microvascular Reconstruction of Maxillomandibular Defects

“…The radial forearm flap has been used for reconstruction of palatal defects and for total lower lip reconstruction. [22,23] It is suggested to use a full-thickness skin graft from the neck to cover the radial forearm free flap donor site in patients undergoing neck dissection and microvascular reconstruction for ablative head and neck oncologic surgery. The primary advantage is avoiding a third surgical site.…”

Microsurgical Reconstruction of Extensive Lower Lip Defects

“…1 Although good outcomes are reported for the use of composite radial forearm-PL tendon free flaps, most data come from case reports or small case series. [1][2][3][5][6][7][8][9] Several other techniques have also been reported for lower lip reconstruction. Composite anterolateral thigh (ALT) free flap and FL offer a good alternative, significantly reducing donor site morbidity.…”