Karapandzic Flap for Functional &amp; Cosmetic Reconstruction of Lower Lip Cancer with Review of Literature

Sachin S Kadam,Tejaswini Kadam,Saurabh Phadke

doi:10.31579/2640-1053/099

Abstract

The incidence and prevalence of lip and oral cavity cancer has increased over the last decade, worldwide and in India. It ranks at 1st position in males in india, all ages, in 2020. Lips are essential organ of the body which carries dynamic role in facial expression, speech, sensuality, deglutition. Resection of central, large, lower lip cancer creates a more than 2/3rd large defect. Covering of this defect with maintenance of oral competency is a difficult task for a treating surgeon. Number of techniques are described for covering of large lower lip defects. Out of these techniques, karapandzic flap is a successful, accepted, simple, easy to learn reconstructive procedure with good cosmetic results. It is a modification of Gillie’s fan flap and it involves unilateral or bilateral full-thickness circumoral advancement-rotation flaps. The feature which distinguishes it from other techniques is preservation of neuro-vascular integrity, symmetry and oral competency. We are reporting a case of an elderly gentleman with large, central, lower lip cancer who underwent oncological resection with reconstruction by karapandzic flap technique.

Highlights

Human lips are considered as the dynamic organ of the body as they are responsible for multiple functions like facial expression, articulation of speech, deglutition, and containment of salivary secretions
In India, lip and oral cavity cancer ranks at 1st position in males, all ages with incidence 16.2 % and 13.5% incidence in both sexes, all ages in 2020 [4]
We are reporting a case of an elderly gentleman with large, central, lower lip cancer who underwent oncological resection with reconstruction by karapandzic flap

Summary

Introduction

Human lips are considered as the dynamic organ of the body as they are responsible for multiple functions like facial expression, articulation of speech, deglutition, and containment of salivary secretions. We are reporting a case of an elderly gentleman with large, central, lower lip cancer who underwent oncological resection with reconstruction by karapandzic flap. A 51 year old gentleman with no co-morbidity with Eastern Cooperative Oncology Group Performance Status 1 (ECOG –PS 1) presented to our clinic with ulero-proliferative lesion over the lower lip for the last 4 months He had an addiction of tobacco chewing and he used to consume it, 8-9 times per day for the last 30 years. We had planned surgery after getting fitness from physician and anesthesist He underwent surgery with wide local excision of the lower lip lesion with bilateral selective neck dissection (Level I to IV) with reconstruction by karapandzic flap. After excision of the lesion [Fig. 3, 4], bilateral nasolabial folds are mobilised maintaining neurovascular structures These mobilised full thickness circumoral advancement flaps are rotated and a new lower lip was reconstructed [Fig. 5, 6]. After completion of follow up period of one year post treatment [Fig. 8], he is still disease free

Discussion

Findings

Disclosures