Functional and aesthetic results obtained by modified Bernard reconstruction technique after tumour excision in lower lip cancers

Tuna, Evrim E. Ünsal; Öksüzler, Özgür; Özbek, Cem; Özdem, Cafer

doi:10.1016/j.bjps.2009.02.073

Cited by 20 publications

(6 citation statements)

References 18 publications

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“…However, this method limit to the elderly patients only or patients with facial tissue laxity as the tension of lower lip skin tissue after surgery would give rise to microstomia of patients. 21,22 Since the subjects included in this study were all young patients whose facial tissue was tense and with a large full-thickness defect in the lower lip, it was difficult to achieve the expected surgical goal simply by applying Bernard flap. After Bernard flap repair, the average mouth width of the patients was 3.18 AE 0.31 cm, and the average height of mouth opening was only 1.32 AE 0.22 cm.…”

Section: Discussionmentioning

confidence: 99%

Application of Local Flaps in Repairing Total and Near-Total Lower Lip Defects of Young Patients

Wang

et al. 2021

Journal of Craniofacial Surgery

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Background: It has always been a great challenge for clinical doctors to reconstruct total and near-total lower lip defects. Compared with elderly patients, the repair operation in young patients is more difficult where free flaps are usually used for transfer. In order to obtain better postoperative results, the authors combined two kinds of local skin flaps for operation purpose, and evaluated their postoperative clinical effects. Methods: From April 2011 to May 2019, a total of 5 young patients with lower lip tumor or trauma were included in this study, with an average age of 30.4 years old. The lesion was all resected and resulted in a defect of 87% to total area of the lower lip, accompanied by a partial defect of the chin each. To repair the defect of the lower lip, the authors firstly used the modified Bernard flap. Then the authors designed the double Abbe flap to perform the operation according to the recovery of the patient 3 months later than the first operation. Finally, the outcomes of either operation were compared upon slit width, mouth opening height, aesthetics, and function of the patients, and statistically analyzed the results. Results: All patients underwent the repair of modified Bernard flaps and double Abbe flaps of with no hemodynamic disorder of the flaps and well-recovery. At 3 months after the operation, the average gap width of lip was 4.34 AE 0.24 cm, the average opening height was 3.18 AE 0.28 cm, the average aesthetic score was 7.98 AE 0.51 (full score of 10), and the average functional score was 11.4 AE 0.55 (full score of 12). The 5 patients showed no obvious scar but a good shape on the lower lip. The function of eating, pronunciation, expression of feelings and smiling change were close to normal. Three patients had mild numbness in the lower lip, while the other two had normal sensory function. Conclusion:Combined modified Bernard flap and double Abbe flaps can bring out promising reparative outcomes of near-total or total lower lip defects in lower lip in young patients with good aesthetic and functional recovery, which is recommended while considering surgical alternatives.

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Section: Discussionmentioning

confidence: 99%

Application of Local Flaps in Repairing Total and Near-Total Lower Lip Defects of Young Patients

Wang

et al. 2021

Journal of Craniofacial Surgery

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“…The lip functions and aesthetic appearance were assessed at least 1 year later. The scoring system consists of a functional assessment and aesthetic assessment [ 11 ]. The functional assessment included evaluations of sensitivity, competence, and mouth opening.…”

Section: Discussionmentioning

confidence: 99%

Combined Rotation and Advancement Flap Reconstruction for a Defect of the Upper Lip: 2 Cases

Lee

Jung

et al. 2012

Arch Plast Surg

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Many types of upper lip reconstruction have been introduced to treat defects after a tumor excision or trauma. The authors treated two cases of upper lip defects. A 35-year-old woman presented with a squamous cell carcinoma of the left upper lip that had invaded the corner of the mouth. After resecting the tumor, the defect was 3.7×3.5 cm in size. A 52-year-old woman presented with a dog bite of the right upper lip. The defect measured 4.0×2.2 cm in size. The two cases were reconstructed by combined rotation and advancement of a cheek flap. This technique produced a good functional outcome that allowed for oral competence and created an opening of adequate size. A combination of rotation and an advancement flap can be used to treat upper lip defects in a single-stage procedure. This approach produces a good functional and cosmetic outcome.

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“…However, most cases requiring reconstruction result from tumor ablation 2 . Surgeons worldwide have made efforts to devise new methods and improve surgical techniques, varying from primary closing and local flaps to free flap transfer, each of which has its advantages and disadvantages 3–8 …”

Section: Introductionmentioning

confidence: 99%

“…2 Surgeons worldwide have made efforts to devise new methods and improve surgical techniques, varying from primary closing and local flaps to free flap transfer, each of which has its advantages and disadvantages. [3][4][5][6][7][8] Major lower lip defects have been repaired in many ways, including flaps from the chin, cheek, or upper lip, considering the defect dimensions and position, patient comorbidities, and surgeon's experience. Lip switch flaps are effective for moderate lip defects but require a second stage to divide the vascular pedicle and can cause microstomia.…”

Section: Introductionmentioning

confidence: 99%

Lower lip reconstruction using McGregor fan technique with or without depressor anguli oris chimeric flap. Is there a difference in function and aesthetic outcomes?

et al. 2023

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Background Lower lip reconstruction aims to maintain facial subunit function and aesthetics. We present a minor modification of the McGregor flap technique, in which depressor anguli oris (DAO) muscle is separately elevated as a chimeric flap together to investigate the outcomes for reconstructing lower lip defects using various functional parameters. Methods The study included patients who underwent surgical repair of lower lip defects using a McGregor fan flap with or without DAO muscle chimeric flap between January 2018 and May 2021. The patients were divided into our modified technique with DAO chimeric flap (study group) and conventional McGregor (control group). The primary outcomes were functional evaluation of oral competency, speech intelligibility, and tactile sensation of reconstructed lip outcomes. The functional satisfaction and Patient and Observer Scar Assessment Scale (POSAS) were analyzed. Results A total of 20 patients were enrolled (10 patients for each group). Excellent oral competence was present in 12 patients, favorably significant in patients with DAO chimeric flap (n = 8/10, p = 0.018). All patients had intelligible speech with insignificant differences between the two groups. No patients demonstrated differences to light touch from baseline sensation at 1 year. Patients in the study group reported more lip function satisfaction (p = 0.049). The POSAS score indicates satisfaction with the appearance of all patients. Conclusion McGregor fan technique combined with DAO muscle chimeric flap offers a good choice by maintaining sensory and motor functions. Our minor modification can ensure the integrity of the oral sphincter, leading to improved lower lip function.

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Functional and aesthetic results obtained by modified Bernard reconstruction technique after tumour excision in lower lip cancers

Cited by 20 publications

References 18 publications

Application of Local Flaps in Repairing Total and Near-Total Lower Lip Defects of Young Patients

Application of Local Flaps in Repairing Total and Near-Total Lower Lip Defects of Young Patients

Combined Rotation and Advancement Flap Reconstruction for a Defect of the Upper Lip: 2 Cases

Lower lip reconstruction using McGregor fan technique with or without depressor anguli oris chimeric flap. Is there a difference in function and aesthetic outcomes?

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