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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.

International Journal of Oral and Maxillofacial Surgery
|May 24, 2017
PubMed
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.

Keywords:
free flapfunctional reconstructionlower lipserratus anterior muscle

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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.