Total Lower Lip Reconstruction in Advanced Squamous Carcinoma: Application of the Gate-Flap Technique

Gürel, Mehmet Salih; Alic, B.; Seyhan, Ahmet; M, Cilengir

doi:10.1097/00000637-199205000-00007

Cited by 22 publications

(8 citation statements)

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“…In those patients with extensive lower-lip defects involving the mental nerves, the bilateral musculocutaneous unequal-Z procedure seems to be a very useful technique to provide a sensitive lower lip reconstruction. In contrast with the other local procedures, [13][14][15][16]18 the skin incisions used in our technique do not cross the courses of the branches coming from the major cutaneous nerves of the face such as the infraorbital and buccal nerves (Fig. 6).…”

Section: Discussionmentioning

confidence: 99%

“…12 However, larger defects require more complex surgical procedures. Although some local procedures, including bilateral gate flaps, 13,14 Bernard-Webster technique, 15 modified Webster procedure, 16 double cross-lip flap, 17 and the DAO musculocutaneous flap, 18 have been reported for reconstruction of large lower-lip defects involving more than 80% of the lower lip, these techniques are solely useful for elderly patients with extreme facial laxity. They often result in severe microstomy in younger patients.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Musculocutaneous Unequal-Z Procedure

Mutaf

Bulut

Sunay

et al. 2008

Annals of Plastic Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral Musculocutaneous Unequal-Z Procedure

Mutaf

Bulut

Sunay

et al. 2008

Annals of Plastic Surgery

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“…26 However, successful reconstruction of the total lower lip with the gate-flap technique has been reported. 27 …”

Section: Nasolabial Flapsmentioning

confidence: 99%

“…Regarding their function and sensibility, some doubts exist. 4,6,27 Regional Flaps Sternocleidomastoideus or deltopectoral flaps 15,16 are very voluminous and require a two-stage procedure. Also, they cause bulkiness on the neck and an unpleasant appearance of the donor sites.…”

Section: General Commentmentioning

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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“…Various reconstruction techniques for lower lip defects have been described in the literature. Musculocutaneous flap transfers are commonly advocated for reconstruction of the lip defects to maintain the oral competence (3)(4)(5)(6)(7)(8)(9). The most important factor is the size of lower lip defect for determining the reconstructive method to be employed.…”

mentioning

confidence: 99%