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Pang P, Xue X, Xu Z, Duan W, Liu F, Tan X, Zhang E, Qi Z, Sun C. Functional reconstruction of lip defects. Oral Oncol 2024; 159:107055. [PMID: 39551009 DOI: 10.1016/j.oraloncology.2024.107055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 08/28/2024] [Accepted: 09/23/2024] [Indexed: 11/19/2024]
Abstract
The lip is a crucial structure in the oral and maxillofacial region, serving vital physiological functions such as speech, swallowing, chewing, and expression. Due to the complexity of lip anatomy, function, and the various types of defects, the functional restoration and reconstruction of lip defects remain complex and challenging tasks. In this article, we summarize several methods for functional restoration and reconstruction of lip defects using local flaps that carry the depressor anguli oris muscle, as well as some free flaps. We also introduce methods for repairing extensive defects in the oral and maxillofacial region that are accompanied by lip defects using combinations of various tissue flaps.
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Affiliation(s)
- Pai Pang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Xiaomeng Xue
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Zhongfei Xu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Weiyi Duan
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Fayu Liu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Xuexin Tan
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Enjiao Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China
| | - Zhongzheng Qi
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China.
| | - Changfu Sun
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No.117, Nanjing Bei Street, Heping District, Shenyang, Liaoning 110002, PR China.
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Murray-Douglass A, Romeo P, Fox C. Free Flap Reconstruction of the Lower Lip: A Systematic Review and Meta-Analysis. J Reconstr Microsurg 2024. [PMID: 39047789 DOI: 10.1055/s-0044-1788543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND Large defects of the lower lip often require free tissue coverage. Fasciocutaneous free flaps have been traditionally used, but innervated muscular free flaps may fundamentally address orbicularis oris deficiency and improve dynamic competence. This review aimed to determine if innervated muscular free flaps provided benefit over fasciocutaneous free flaps for reconstruction of defects of more than 50% of the lower lip. Outcomes of interest included functional oral outcomes including oral competence, aesthetic outcomes, and patient-reported outcome measures. METHODS Five databases (PubMed, Embase, Web of Science, CINAHL, and CENTRAL) were searched for variations of "lip" and "free flap." Two authors screened articles and included primary research of free flap reconstruction of more than 50% of the lower lip from any etiology in living humans with an English full-text available. Composite bony flaps were excluded. Oral competence and aesthetic satisfaction, reconstruction details, and complications were extracted. Proportional meta-analyses were used to synthesize results for fasciocutaneous free flaps, which were compared with those for muscular free flaps. RESULTS Fifty-nine articles describing 242 patients were included. Muscular free flaps reported significantly higher proportional oral competence than fasciocutaneous free flaps (98 vs. 83%, p = 0.01). Aesthetic outcomes (98 vs. 97%, p = 0.22) and complications (17 vs. 18%, p = 0.79) were equivalent between fasciocutaneous and muscular free flaps. CONCLUSION Muscular free flaps may address the fundamental orbicularis oris defect that causes oral incompetence and seem to provide better functional results. Aesthetic outcomes and complications seem to be equivalent.
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Affiliation(s)
- Alexander Murray-Douglass
- Department of Plastic and Reconstructive Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Pascalino Romeo
- Department of Plastic and Reconstructive Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Carly Fox
- Department of Plastic and Reconstructive Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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