[Total reconstruction of the lower lip: Lip suspension technique by double nasolabial rigging and review of the literature].

Autor: Tourrier M; Service de chirurgie plastique et reconstructrice, hôpital Henri-Duffaut, 305, rue Raoul-Follereau, 84000 Avignon, France. Electronic address: tourrier.marie@gmail.com., Honeyman CS; Department of Plastic and Reconstructive Surgery, St John's Hospital, Livingston, Scotland, United Kingdom., Lopez MA; Service de chirurgie plastique, esthétique et reconstructrice, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, Marseille, France., Casanova D; Service de chirurgie plastique, esthétique et reconstructrice, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, Marseille, France., Grandpierre X; Service de chirurgie plastique et reconstructrice, hôpital Henri-Duffaut, 305, rue Raoul-Follereau, 84000 Avignon, France., Bertrand B; Service de chirurgie plastique, esthétique et reconstructrice, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, Marseille, France., Martin D; 35, avenue des Pins, Marseille, France.
Jazyk: francouzština
Zdroj: Annales de chirurgie plastique et esthetique [Ann Chir Plast Esthet] 2021 Apr; Vol. 66 (2), pp. 167-173. Date of Electronic Publication: 2020 Jun 19.
DOI: 10.1016/j.anplas.2020.05.007
Abstrakt: Background: Total lower lip defect is rare and its reconstruction difficult. The challenges are both aesthetic and functional. Suspension of the lower lip is essential for restoring oral competence. We report an original and simple technique of suspension by double nasolabial rigging.
Method: Two upper base orbitonasolabial flaps, extended over several centimeters below the lip commissures are raised. The epidermis is completely removed. Then, the flaps are tunneled under the skin and fixed to the reconstructed lower lip in order to provide it with effective suspension to the maxillary.
Results: In our experience, we used the nasolabial rigging associated with a total reconstruction of the lower lip for three patients. Lip continence is effective in the long term. The review of literature shows that the use of conventional locoregional flaps restores a good labial competence but is limited to subtotal lower lip defect. Distant pedicled flaps or free flaps made without suspension of the lower lip don't restore the labial competence. Several procedures to suspend the lower lip with strips of fascia lata or tendon of palmaris longus, associated or not with a free flap, seem to provide satisfactory oral competence. All these techniques are poorly standardized and technically difficult.
Conclusion: The technique of the double nasolabial rigging that we describe seems to be an effective and interesting alternative by its simplicity, its reproducibility and its adaptability. It allows to obtain a perfectly fixed posterior plane, able to receive any reconstruction of the lower lip.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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