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Adding versatility to the reconstruction of intraoral lining: opened pocket method
Can Cinar1, Simin Ogur, Hakan Arslan
1Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. cinarc@tnn.net
The Journal of Craniofacial Surgery
|January 26, 2007
Summary
A prefabricated scapular free flap with an "opened pocket" technique effectively reconstructs large cheek and lip defects after cancer surgery when other flaps fail. This method restores oral lining and function, offering a viable alternative for complex cases.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Oral and Maxillofacial Surgery
Background:
- Reconstructing full-thickness cheek defects with significant lip involvement is challenging.
- The radial forearm flap is commonly used for oral lining but may not always be suitable.
- Alternative free flaps are necessary for complex perioral cancer reconstructions.
Observation:
- A prefabricated scapular fasciocutaneous flap was used to reconstruct a large lip and cheek defect post-cancer ablation.
- A novel "opened pocket" technique was employed to create the intra-oral lining without flap folding.
- The flap was grafted and then incised to form the neo-lips and oral commissure.
Findings:
- The prefabricated scapular flap successfully reconstructed the extensive defect, including 45% of the upper lip and 50% of the lower lip.
- The "opened pocket" method facilitated restoration of the intra-oral lining with adequate labial sulci.
- The patient achieved satisfactory oral competence, appearance, and resumed a soft diet within 10 days post-operation.
Implications:
- Prefabricated scapular free flaps are a viable option for complex lip and cheek reconstruction when standard flaps are unavailable.
- The "opened pocket" technique enhances flexibility and reduces stress in intra-oral lining reconstruction.
- This approach improves functional and aesthetic outcomes in patients with extensive perioral defects.