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Lip reconstruction using a functioning serratus anterior free flap: preliminary study.
A O Gundeslioglu1, E C Karadag1, I Inan1
1Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Medical Faculty of Meram, Konya, Turkey.
Summary
Innervated serratus anterior muscle free flaps offer a reliable solution for lip reconstruction after cancer surgery. This technique successfully restored oral sphincter function and improved lip aesthetics in patients.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Lip defects, often resulting from cancer resection, necessitate functional and aesthetic reconstruction.
- While traditional free tissue transfers are used, innervated muscle flaps may offer superior functional outcomes.
Purpose of the Study:
- To evaluate the efficacy of innervated serratus anterior muscle free flaps for lip reconstruction.
- To assess functional recovery, specifically oral sphincter function and reinnervation, following this reconstructive technique.
Main Methods:
- Five patients with significant lip defects due to squamous cell carcinoma underwent reconstruction using innervated serratus anterior muscle free flaps.
- Vascular anastomosis to the facial artery and nerve coaptation with the marginal mandibular branch of the facial nerve were performed.
- Split-thickness skin grafts were used for flap coverage, and electromyography monitored muscle reinnervation.
Main Results:
- All patients survived the procedure.
- Three patients achieved complete oral sphincter function without drooling.
- Postoperative electromyography confirmed successful reinnervation of the serratus anterior muscle at one year.
Conclusions:
- Innervated serratus anterior muscle free flaps are a viable and effective option for complex lip reconstruction.
- This method provides functional restoration of the oral sphincter, improving quality of life for patients with lip defects.
