Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice
Summary:. Local flaps from the upper lip and cheeks have been the first choice for two-thirds to total resection of the lower lip. However, these local flap techniques involve many clinical problems, including small a mouth, drooling, scarring, and hypesthesia. The improvement of free anterolateral...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2023-05-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005003 |
| _version_ | 1797792094787469312 |
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| author | Itaru Tsuge, MD, PhD Hiroki Yamanaka, MD, PhD Motoki Katsube, MD, PhD Yoshihiro Sowa, MD, PhD Michiharu Sakamoto, MD, PhD Naoki Morimoto, MD, PhD |
| author_facet | Itaru Tsuge, MD, PhD Hiroki Yamanaka, MD, PhD Motoki Katsube, MD, PhD Yoshihiro Sowa, MD, PhD Michiharu Sakamoto, MD, PhD Naoki Morimoto, MD, PhD |
| author_sort | Itaru Tsuge, MD, PhD |
| collection | DOAJ |
| description | Summary:. Local flaps from the upper lip and cheeks have been the first choice for two-thirds to total resection of the lower lip. However, these local flap techniques involve many clinical problems, including small a mouth, drooling, scarring, and hypesthesia. The improvement of free anterolateral thigh (ALT) flap transfer can solve these problems with expansion of the application of free flaps for lower lip reconstruction. The patient in this case was a 56-year-old man with squamous cell carcinoma of the lower lip (cT3N1M0). Subtotal lower lip resection preserving both corners of the mouth with bilateral neck dissection was performed. Simultaneously, a sensory ALT flap was elevated with an 8 × 6 cm skin island and a lateral femoral cutaneous nerve. The lateral and medial sides of the fascia lata were processed into 1-cm-wide strings, which were tunneled through the orbicularis oris muscle of the upper lip and sutured to the orbicularis oris muscle at the mucosal side of the philtrum. The lateral femoral cutaneous nerve and right mental nerve were sutured. At 3 months, a second surgery was performed to replace the ALT flap on the white labial side with a clavicle full-thickness skin graft. This surgery achieved four important factors: opening and closing of the mouth, sensory function of the lower lip, cosmetic appearance, and minimization of donor-site damage. We believe the worldwide improvement of microsurgery techniques enables lower lip reconstruction using the sensory ALT flap to be selected as the first choice for two-thirds to total lower lip defects. |
| first_indexed | 2024-03-13T02:28:17Z |
| format | Article |
| id | doaj.art-7bed8ff8107b411d8a65c8e9da421e42 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-13T02:28:17Z |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-7bed8ff8107b411d8a65c8e9da421e422023-06-30T01:48:44ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-05-01115e500310.1097/GOX.0000000000005003202305000-00035Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First ChoiceItaru Tsuge, MD, PhD0Hiroki Yamanaka, MD, PhD1Motoki Katsube, MD, PhD2Yoshihiro Sowa, MD, PhD3Michiharu Sakamoto, MD, PhD4Naoki Morimoto, MD, PhD5From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanFrom the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanFrom the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanFrom the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanFrom the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanFrom the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanSummary:. Local flaps from the upper lip and cheeks have been the first choice for two-thirds to total resection of the lower lip. However, these local flap techniques involve many clinical problems, including small a mouth, drooling, scarring, and hypesthesia. The improvement of free anterolateral thigh (ALT) flap transfer can solve these problems with expansion of the application of free flaps for lower lip reconstruction. The patient in this case was a 56-year-old man with squamous cell carcinoma of the lower lip (cT3N1M0). Subtotal lower lip resection preserving both corners of the mouth with bilateral neck dissection was performed. Simultaneously, a sensory ALT flap was elevated with an 8 × 6 cm skin island and a lateral femoral cutaneous nerve. The lateral and medial sides of the fascia lata were processed into 1-cm-wide strings, which were tunneled through the orbicularis oris muscle of the upper lip and sutured to the orbicularis oris muscle at the mucosal side of the philtrum. The lateral femoral cutaneous nerve and right mental nerve were sutured. At 3 months, a second surgery was performed to replace the ALT flap on the white labial side with a clavicle full-thickness skin graft. This surgery achieved four important factors: opening and closing of the mouth, sensory function of the lower lip, cosmetic appearance, and minimization of donor-site damage. We believe the worldwide improvement of microsurgery techniques enables lower lip reconstruction using the sensory ALT flap to be selected as the first choice for two-thirds to total lower lip defects.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005003 |
| spellingShingle | Itaru Tsuge, MD, PhD Hiroki Yamanaka, MD, PhD Motoki Katsube, MD, PhD Yoshihiro Sowa, MD, PhD Michiharu Sakamoto, MD, PhD Naoki Morimoto, MD, PhD Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice Plastic and Reconstructive Surgery, Global Open |
| title | Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice |
| title_full | Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice |
| title_fullStr | Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice |
| title_full_unstemmed | Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice |
| title_short | Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice |
| title_sort | lower lip reconstruction using a sensory anterolateral thigh flap as the first choice |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005003 |
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