Applications of the Karapandzic principle of lip reconstruction after excision of lip cancer

Jabaley, Michael E.; Orcutt, Thomas W.; R, Clément

doi:10.1016/0002-9610(76)90333-0

Cited by 41 publications

(18 citation statements)

References 10 publications

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“…The numbers are small when compared with subtotal or partial defects, in which the treatment is different and easier. The cases presented contradict the accepted dogma that reconstruction of the muscular layer of the lip is mandatory for normal function and appearance [2,7,8,16,17,18]. In our patients the majority of lips (7/10) were reconstructed without any muscle tissue.…”

Section: Discussioncontrasting

confidence: 75%

“…The use of full-thickness nasolabial tissue may denervate the upper lip muscle to a great degree [2,3]. Moreover, the innervation of musculocutaneous flaps is naturally deficient [6,7,11], whereas the almost inevitable excessive tension narrowing of the oral fissure and lip retrusion are unacceptable [2,3,8,9]. In addition, the problem of reconstructed lip flattening is seen in other procedures based on similar principles, especially to the fortunately abandoned Dieffenbach [4] method.…”

Section: Discussionmentioning

confidence: 99%

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Total lower lip reconstruction

Kobus¹

2003

Eur J Plast Surg

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Ten cases of total lower lip reconstruction are reviewed. The total lip defects resulted from tumor resection (n=6), trauma (n=3), and noma (n=1). There were concomitant chin and mandible defects in three and four patients. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patient's age, sex, occupation, and general health. Local procedures and tissue transposition from the head and neck region were used in eight cases; distant flaps were necessary in two cases. All patients achieved satisfactory functional and esthetic results. The author's experience and evaluation of various surgical methods are presented with special regard to the combined use of local and distant tissue to achieve an optimal outcome.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Total lower lip reconstruction

Kobus¹

2003

Eur J Plast Surg

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“…Microstomia always results but rarely causes significant problems: Properly speaking and nondrooling patients rarely complain of microstomia. 24 The long-term results show some evidence of surgical intervention, and Jackson 5 recommended this technique particularly for subtotal (up to three quarters) reconstruction of the lower lip.…”

Section: Rotation Flap Using the Residual Lipmentioning

confidence: 99%

Lower Lip Reconstruction Using a Functioning Gracilis Muscle Free Flap

Ninković

Spilimbergo

Evans

et al. 2010

Seminars in Plastic Surgery

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The lips are highly visible structures on the face, providing oral competence and expressing emotion. The reconstruction of large full-thickness defects of the lips is a formidable challenge for the plastic surgeon. The most challenging defect of the lower lip is full thickness, larger than two thirds. Such an extensive defect requires either staged reconstruction or a flap of distant tissue. We consider that the gracilis muscle, due to its anatomic and functional features, is the ideal flap for reconstruction of the lips. A functioning gracilis matches all the requisites and allows normal movements that are uniform to all of the lip. The new commissure is symmetric and moves simultaneously with the residual commissure due to innervation by the facial nerve. Our indications to use the functioning gracilis muscle flap in lip reconstruction are as follows: resection of the lower lip larger than one quarter of the lip length in a patient younger than 60 years; resection larger than one third of the lip in all patients. When performing a free gracilis flap for lip reconstruction, we consider that, if possible, a facial artery musculomucosal flap and sensitive neurotization should be included to restore sensation of the reconstructed lip.

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“…These supporting muscles of the lips are combined into 1 unit to modulate and fine tune orbicularis oris position. 21 The buccinator is the primary muscle of the cheek. The buccinator compresses the cheek and assists in mastication.…”

Section: Arch Facial Plast Surg 2005;7:347-352mentioning

confidence: 99%

“…Jabaley and colleagues 21 described their experiences with the Karapandzic flap. 21 The primary shortcomings of the Karapandzic flap in their experience included underprojection of the lower lip, tightness of the lower lip, and microstomia that is invariably seen with this flap. Total lip defects and defects larger than 80% of lip length would be candidates for reconstruction via larger composite flaps, cheek flaps, or possible free-tissue transfer flaps.…”

Section: Commentmentioning

confidence: 99%

The Split Orbicularis Myomucosal Flap for Lower Lip Reconstruction

Ducic

Athre²,

Cochran

2005

Archives of Facial Plastic Surgery

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To describe the split orbicularis myomucosal flap and to review our center's experience with this technique for large defects of the lower lip.Methods: All patients presenting to the senior author (Y.D.) for lower lip reconstruction using this flap were reviewed in a retrospective fashion.Results: A total of 14 patients with a minimum follow-up of 6 months (mean, 3.4 years; range, 6 months to 5 years) underwent lower lip reconstruction using the split orbicularis myomucosal flap from May 1999 to May 2004. Twelve of the defects arose as a result of cancer resection (squamous cell carcinoma [n=8], basal cell carcinoma [n=3], and melanoma [n = 1]), and 2 arose sec-ondary to trauma. The defect crossed the vermilion in two thirds of the cases, extending for a variable distance onto the cutaneous portion of the lower lip. The defect size varied from 50% to 80% of the transverse dimension of the lower lip (mean, 68%) and involved the commissure in 4 patients. There were no flap failures, facial nerve palsies or paralyses, oral incompetence, or need for scar revision in any of our study population. Conclusion:The split orbicularis myomucosal flap is a reliable method of reconstructing significant defects of up to 80% of the lower lip with minimal risks of microstomia or functional impairment.

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Applications of the Karapandzic principle of lip reconstruction after excision of lip cancer

Cited by 41 publications

References 10 publications

Total lower lip reconstruction

Total lower lip reconstruction

Lower Lip Reconstruction Using a Functioning Gracilis Muscle Free Flap

The Split Orbicularis Myomucosal Flap for Lower Lip Reconstruction

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