Abstract
BackgroundLip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results. Abbé flaps offer an excellent reconstructive option but are limited to defects under 65 %.MethodsWe describe a two-stage “modified Abbé island flap” technique whereby a full-thickness myocutaneous flap is combined with a modified Karapandzic flap, allowing for reconstruction of total and near total lip defects.ResultsSix patients underwent successful two-stage lower and upper lip reconstruction with this technique. Oral competence and satisfactory aesthetic outcomes were achieved in all six cases. There were no complications. Although microstomia was noted to a certain extent, we argue this impact to be less than the morbidity of a free flap that lacks sphincteric function.ConclusionThe “Modified Abbé Island Flap” can be used to reconstruct near-total lip defects using locally innervated, well-vascularized tissues that recreate the oral sphincter and restore oral competence. The combination of the conventional Abbé flap with a modified Karapandzic flap provides reliable results and significantly reduces operating time.
Highlights
Lip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results
Before the advent of free-tissue transfer, large lip defects of over two-thirds the length of the lip were reconstructed using bilateral Gillies or Karapandzic flaps [1] which resulted in cheek tissue de-enervation, compromised oral competence, significant microstomia, and inferior aesthetic outcomes
We describe sixlip reconstruction cases performed successfully using a combined Abbé and modified Karapandzic flap
Summary
Before the advent of free-tissue transfer, large lip defects of over two-thirds the length of the lip were reconstructed using bilateral Gillies or Karapandzic flaps [1] which resulted in cheek tissue de-enervation, compromised oral competence, significant microstomia, and inferior aesthetic outcomes. Lip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results. Methods: We describe a two-stage “modified Abbé island flap” technique whereby a full-thickness myocutaneous flap is combined with a modified Karapandzic flap, allowing for reconstruction of total and near total lip defects
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