Total Lower Lip Reconstruction with a Sensate Composite Radial Forearm-Palmaris Longus Free Flap and a Tongue Flap

Serletti, Joseph M.; Tavin, Ellis; Moran, Steven L.; Coniglio, John U.

doi:10.1097/00006534-199702000-00041

Cited by 67 publications

(43 citation statements)

References 5 publications

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“…Advantages of this flap are good color texture match, glabrousness, ease of dissection, great length, and large diameter of the vascular pedicle and the possibility of becoming a sensate flap. 6 Disadvantages include small skin paddle, sacrifice of one of two major arteries of the hand, donor site scar, and the risk of tendon exposure. Thus, Jeng and colleagues 4 and Serkan and others 1 reported that the composite anterolateral thightensor fasciae latae flap could be a good alternative.…”

Section: Discussionmentioning

confidence: 99%

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One-stage reconstruction of large lower lip defect and oral competence with free composite anterolateral thigh-tensor fasciae latae flap

Tzeng

Chien

Lin

et al. 2012

Formosan Journal of Surgery

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KEYWORDSanterolateral thigh flap; lower lip reconstruction; sialorrhea; tensor fasciae latae Summary Reconstruction for a large lower lip defect is a challenge to reconstructive surgeons. The most challenging problem is to maintain oral competence and prevent sialorrhea. We present three cases of such a defect reconstructed with composite anterolateral thightensor fascia lata free flaps in one stage. The patients reported in this communication had advanced squamous cell carcinoma in the lower lip. A large lower lip defect (>90%) resulted in each case from wide excision of the tumor. A composite anterolateral thigh-tensor fasciae latae free flap was used to reconstruct the defect and to restore the dynamic oral competence in one stage. A tensor fasciae latae sling was attached by two strips sutured together to the upper orbicularis oris muscle in the first case. The four-strip method, a modification of the method described by Serkan, 1 was adopted in the second case. The upper two strips bilaterally sutured to the orbicularis oris muscles in a mode somewhat different from Serkan's method. The tensor fasciae latae sling was attached by two strips sutured to the periosteum of both zygomatic eminences in the third case. The tensor fasciae latae sling of Case 1 failed with persistent sialorrhea. The second case had good oral competence and comprehensible speech ability without sialorrhea. The third case had an acceptable result before he was lost to follow-up. A composite anterolateral thigh-tensor fasciae latae free flap is a good choice for a large lower lip defect to achieve oral competence reconstruction in one stage. Simultaneous dynamic and static suspensions are suggested to maintain oral competence and prevent sialorrhea.

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Section: Discussionmentioning

confidence: 99%

“…These techniques can be categorized as static or dynamic procedures. 1,4,8 Methods of static suspension include use of muscles or a fascia sling anchored permanently to the nasolabial area, 3 periosteum of the zygomatic eminences, 6,13 or bilateral modiolus. 4,7 The major disadvantage of this suspension is sialorrhea when speaking or eating.…”

Section: Discussionmentioning

confidence: 99%

One-stage reconstruction of large lower lip defect and oral competence with free composite anterolateral thigh-tensor fasciae latae flap

Tzeng

Chien

Lin

et al. 2012

Formosan Journal of Surgery

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“…The free radial forearm flap, originally described by Song [18], was used by Sadove [16] and Serletti [17] in reconstruction of the lower lip after resection of malignant tumours. It has one of the longest available vascular pedicles, thus the microsurgical anastomoses can be performed far away from the infected and fibrosed tissues, preferentially in the neck area.…”

Section: Discussionmentioning

confidence: 99%

“…In this situation the defects in the perioral and midface region were reconstructed with the free radial forearm flap. This flap has been used successfully in oral and facial reconstruction after tumour resection [16,17].…”

Section: Introductionmentioning

confidence: 99%

The free radial forearm flap for reconstruction of facial defects in noma patients

Noever¹,

Feurer²

2000

E J Plastic Surg

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Within a 2-year period ten patients aged 5-22 years were treated for facial sequelae of noma. In six cases free radial forearm flaps were used, combined with local and regional flaps. The indications were defects located in the midface and perioral area. There were no free or regional flap losses in this series. The aesthetic and functional results were appreciated by the patients and there were no functional problems related to the donor area because a suprafascial flap dissection technique was used. In our experience the free radial forearm flap is a valuable option for facial reconstruction in NOMA cases. The advantages include: (1) A very long and large calibre pedicle; (2) thin and pliable flaps of variable size and configuration; (3) the possibility of single stage reconstruction in selected cases. The disadvantages include the not always ideal colour match, both in black patients and in white, and the unsightly donor area which, however, has never led to functional problems.

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“…[1][2][3][4] Traditional reconstructive procedures in the head and neck region include combinations of skin grafting, local flaps, tissue expansion, prefabrication, and free tissue transfers. [4][5][6][7][8][9][10][11][12][13][14] However, the cosmetic outcome of these creative surgical procedures has not proved satisfactory in long-term follow-up because they quite often result in a mask-like appearance that lacks normal facial movement and expression. Furthermore, the patients who undergo this surgery are often subjected to multiple procedures, the aim of which is to optimally improve the appearance and function of the face.…”

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confidence: 99%

Facial Transplantation

Siemionow

Külahçi

2007

Seminars in Plastic Surgery

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The face has functional and aesthetic importance. It represents the most identifiable aspect of an individual's physical being. Its role in a person's identity and ability to communicate can therefore not be overstated. The face also plays an important role in certain functional needs such as speech, communicative competence, eye protection, and emotional expressiveness. The latter function bears significant social and psychological import, because two thirds of our communication takes place through nonverbal facial expressions. Accordingly, the significance of reconstruction of the face is indisputable. Yet despite application of meticulous techniques and the development of innovative approaches, full functional and aesthetic reconstruction of the face remains challenging. This is because optimal reconstruction of specialized units of the face have to address both the functional and aesthetic roles of the face.

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Total Lower Lip Reconstruction with a Sensate Composite Radial Forearm-Palmaris Longus Free Flap and a Tongue Flap

Cited by 67 publications

References 5 publications

One-stage reconstruction of large lower lip defect and oral competence with free composite anterolateral thigh-tensor fasciae latae flap

One-stage reconstruction of large lower lip defect and oral competence with free composite anterolateral thigh-tensor fasciae latae flap

The free radial forearm flap for reconstruction of facial defects in noma patients

Facial Transplantation

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