Bilateral, buccinator myomucosal advancement flaps to reconstruct central upper labial myomucosal defects after ablation of early-stage cancer in minor salivary glands.

Abstract

Reconstruction of upper labial myomucosal defects is surgically challenging. We evaluated whether central defects could be repaired using bilateral, buccinator myomucosal advancement flaps (b-BMAFs). We evaluated five patients with early-stage, minor salivary gland mucoepidermoid carcinomas (low-grade [n=2], intermediate-grade [n=2], and high-grade [n=1]) who underwent central, upper labial myomucosal reconstruction using b-BMAFs after cancer ablation. We treated two men and three women aged 25-59years. Tumors ranged in size from 1.8×1.8 to 2.5×2.2cm. Clinical stages were I and II in two and three patients, respectively. Defect dimensions ranged from 2.8×2.8 to 3.5×3.2cm. All patients underwent successful reconstruction of central, upper labial myomucosal defects using b-BMAFs and were satisfied with the esthetic results. Adequate orbicularis oris and speech function were maintained. No reduction in mouth opening was observed. Patients were followed up for 24-36months; one pulmonary metastasis was observed at 36months postoperatively. Placement of b-BMAFs is safe and feasible when reconstructing central, upper labial myomucosal defects after ablation of early-stage, minor salivary gland cancer.