Abstract
This study compares sensory recovery after total lower lip reconstruction in a wide variety of flaps including bilateral depressor anguli oris flap, submental island flap, bilateral fan flaps, radial forearm flap, and pectoralis major myocutaneous flaps in a large number of patients. Spontaneous return of flap sensation was documented by clinical testing in the majority (3%) of patients who underwent total lower lip reconstruction. Sensory recovery occurred more often in patients with fasciocutaneous free flaps than in those with musculocutaneous flaps. Flap sensation to touch, two-point discrimination, and temperature perception was correlated with age, smoking, and radiation treated patients. We conclude that reasonable sensory recovery may be expected in noninnervated flaps, provided that the major regional sensorial nerve has not been sacrificed, and also provided that the patients age is relatively young and that enough surface contact area of the recipient bed is present without marked scarring. This trial was regestered with Chinese Clinical Trial Registry (Chi CTR) with ChiCTR-ONC-13003656.
Highlights
The reconstruction of an extensive lower defect is a difficult surgical challenge since both aesthetics and function of the lower third of the face have to be restored
In this study we present 125 innervated and noninnervated flaps performed in bothclinics in 65 patients with stage 3 and further squamous cell carcinoma of the total lower lip
Defects of the lower lip were reconstructed in 16 patients with 30 bilateral fan flaps, in 20 patients with 40 karapandzic flaps, in 5 patients with 10 Nakajima flaps, in 2 patients with 4 Fujimori Gate flaps, in patients with bilateral depressor anguli oris flaps, in 5 patients with submental island flaps, in 14 patients with radial forearm free flaps, and in 3 patients with pectoralis major musculocutaneous flaps
Summary
The reconstruction of an extensive lower defect is a difficult surgical challenge since both aesthetics and function of the lower third of the face have to be restored. In order to restore the three layers, several reconstructive procedures have been described, including local flaps from the cheeks, pedicled flaps from the chin, expanded cervical or jugal flaps, and fasciocutaneous free flap transfers [1,2,3,4]. In this study we present 125 innervated and noninnervated flaps performed in bothclinics in 65 patients with stage 3 and further squamous cell carcinoma of the total lower lip. 80 patients have been followed-up for a minimum of 1 year after the tumor resection and reconstruction with bilateral fan flaps, Karapandzic flaps, Nakajima flaps, Fujimori gate flaps, submental island flaps, bilateral depressor anguli oris myocutaneous flaps, pectoralis major myocutaneous flaps, and noninnervated radial forearm flaps was performed
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