Prospective comparative study of lower lip defects reconstruction with different local flaps

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Oncology

Background:

• Squamous cell carcinoma is the most prevalent lip malignancy, frequently affecting the lower lip.
• Lower lip tissue loss necessitates reconstruction, with technique selection based on defect size and location.

Purpose of the Study:

• To evaluate the functional and aesthetic outcomes of different local flaps used for lower lip reconstruction in patients with squamous cell carcinoma.

Main Methods:

• A prospective case series included 41 patients undergoing lower lip reconstruction.
• Defects were categorized by size (<30%, 30-50%, 50-80%, >80%).
• Five local flaps were employed: Karapandzic, double reversed-Abbe, Abbe-Estlander, step-ladder, and reversed-Abbe.

Main Results:

• The double reversed-Abbe flap demonstrated no functional or aesthetic issues at 3 months post-operation.
• Estlander flap resulted in no functional problems but caused lip asymmetry.
• For defects between 50-80%, bilateral reversed-Abbe flaps were superior to Karapandzic flaps.

Conclusions:

• The double reversed-Abbe flap is a highly effective option for lower lip reconstruction, offering superior functional and aesthetic results.
• The Estlander flap is suitable for lateral or commissural defects.
• For moderate to large lower lip defects, bilateral reversed-Abbe flaps are recommended over Karapandzic flaps.