Estratégias em reconstrução do lábio inferior

Abstract

Background:The upper and lower lips represent the most important functional and aesthetic anatomical structures of the lower segment of the face. Given the complex functions of these structures, reconstruction of labial defects presents a challenge for plastic surgeons. Methods: Thirty patients with full-thickness lower lip defects underwent lip reconstruction according to the extent of the defect after tumor resection. Results: Six (20%) patients presented lesions of up to 30% of the total lip surface that required primary closure. Eighteen (60%) patients had lesions of 30-80% of the total area of the lower lip that were repaired using a myomucosal flap; in 14 of these patients, bilateral skin flaps were also used due to cutaneous involvement associated with the resection. Five (16.6%) patients had lesions on the lower lip that were adjacent to the oral commissure; therefore, they underwent reconstruction using an Abbé-Estlander flap with a myomucosal flap and bilateral skin flaps. One (3.5%) patient had a lesion covering 90% of the lower lip that was reconstructed using the Webster-Bernard technique and a tongue flap. Conclusions: Here, we present a simplified, systematic, and literature-based strategy for planning lower lip reconstructions that employs effective and reproducible techniques, which can be used for training resident physicians in the treatment of complex lower lip lesions according to the extent of tissue loss, thereby yielding appropriate aesthetic and functional results.Keywords: Lip/surgery. Surgical flaps. Reconstructive surgical procedures. RESUMO Introdução:Os lábios superiores e inferiores representam as estruturas anatômicas funcionais e estéticas mais importantes do segmento inferior da face. Além disso, possuem funções complexas, sendo a reconstrução de defeitos labiais um desafio ao cirurgião plástico. Método: Trinta pacientes apresentando defeitos de espessura total do lábio inferior foram submetidos a reconstrução do lábio baseada na extensão dos defeitos após exérese tumoral. Resultados: Seis (20%) pacientes apresentavam lesões de até 30% da superfície total do lábio, sendo realizado fechamento primário. Dezoito (60%) pacientes apresentavam lesões de 30% a 80% da superfície total do lábio inferior, sendo realizado retalho miomucoso de vermelhão; em 14 desses pacientes, em decorrência da perda cutânea associada à ressecção, foi associado retalho cutâneo mentolabial. Cinco (16,6%) pacientes tinham lesões no lábio inferior e comissura oral adjacente, sendo submetidos a reconstrução pela técnica This study was performed at

Orofacial Soft Tissue Reconstruction with Locoregional Flaps in a Health Resource-Depleted Environment: Experiences from Nigeria

“…The long reach of the forehead flap to as low as the upper cervical region has been documented [ 19 ]. The nasolabial and myomucosal flaps were the preferred options for lip reconstruction in other studies [ 20 ]. The late presentation of cases with tumor and orofacial gangrene in our environment results in extensive soft tissue defects requiring a locoregional flap that can offer adequate bulk and color match, which is readily provided by the forehead flap.…”

Functional and Aesthetic Lower Lip Reconstruction Using the Yotsuyanagy Flap

“…Lower lip defects can be the result of resection of benign or malignant tumors (where SCC is the most common, which it was diagnosed in all patients of this case series). 8,11,18,25 Other causes are burns, trauma, vascular abnormalities, and congenital malformations. 11,15 The optimal treatment must fulfill the following conditions: (1) the intervention must be early, for this reason, immediate reconstruction was performed in all reported cases; (2) the reconstruction must be functional, reproducing the anatomy that allows proper lip function;…”

Human Bites to the Face Treatment With Pedicle Flap Technique: Case Report

“…The rotated pedicle flap of the upper lip is a surgical technique that provides visually satisfactory results, sufficient vascular pedicle, and correct restoration of the lip contour. (SIQUEIRA et al, 2012;NASCIMENTO et al, 2014). This surgical technique was performed in this case and the patient is satisfied with the aesthetic result and with the preservation of motor and sensory functions in the postoperative follow-up.…”

“…Thorough washing of the wound, associated with antisepsis and antibiotic therapy, leads to successful human bite treatment (ALENCAR et al, 2014). Lips are an important aesthetic-functional element of the face; injuries with tissue loss are thus a challenge in remedial treatment (SIQUEIRA et al, 2012). Lip reconstruction planning must consider the extent of the defect.…”

“…The refore, antibiotic treatment is Fusobacterium nucleatum and Prevotella species are the main pathogens found in infected injuries(BROOK, 2003;REIS et al, 2013).Approximately 20% of human bites are to the face, which can cause significant functional, aesthetic, and psychosocial losses to the patient (ALENCAR et al, 2014). Lips have important functions in speech, facial expression, swallowing and aesthetics; therefore the repair of injuries with tissue loss in this anatomical structure poses a challenge and requires specialized reconstructive techniques(SIQUEIRA et al, 2012;NASCIMENTO et al, 2014).…”