Oral commissure reconstruction with orbicularis oris elastic musculomucosal flaps
| Autor: | Enrico Robotti, P.P. Bonfirraro, Bernardo Righi, Marcello Carminati, Luca Devalle, L. Ortelli, Maria Alessandra Bocchiotti |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Skin Neoplasms Scars Surgical Flaps medicine Humans Vermilion Oral mucosa Reconstruction procedure Facial Injuries Aged Aged 80 and over Mouth business.industry Orbicularis oris muscle Anatomy Commissure Middle Aged Plastic Surgery Procedures Buccinator muscle Lip Surgery stomatognathic diseases medicine.anatomical_structure Carcinoma Squamous Cell Wounds and Injuries Female Wounds Gunshot medicine.symptom business |
| Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 63(3) |
| ISSN: | 1878-0539 |
| Popis: | Surgical reconstruction of the oral commissure aims to restore both symmetry of the lips at rest and, more importantly, full oral competence. Moulding the lip commissure with functional and cosmetic fidelity remains till today a difficult task. A possible surgical solution, the 'elastic flap' principle described by Goldstein, may be found in the wide full-thickness mobilization of the upper and lower vermilion as two composite myocutaneous flaps - tissue sandwiches consisting of labial skin, orbicularis oris muscle and oral mucosa - on the axial pattern of the superior and inferior labial arteries. Based on the contralateral commissure, both flaps are easily 'stretched', accordion-like, to reach the predetermined point of the new commissure, using to full advantage the inherent elastic potential of both vermilions. The fibres of the orbicularis oris muscle at each end of both flaps are embricated to reconstitute a neo-modiolus, which is anchored to the residual buccinator muscle in primary reconstructions, or to the available peri-oral fibrous tissue in secondary procedures. The authors present a select group of 22 patients, who, between 1993 and 2008, underwent this reconstruction procedure for primary or secondary defects involving the oral commissure. The results were generally satisfactory, both functionally and cosmetically. The advantages of this procedure include full restoration of the dynamic function of the orbicularis ring in a single-stage operation and avoidance of either lipswitching procedures or of mobilization of mucosa and cheek skin. The final scars remain well camouflaged within the oral mucosa and the mucocutaneous junction of each lip. |
| Databáze: | OpenAIRE |
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