reconstruction after extensive excision of cancerous lesions
Patients & Methods: The study included 17 patients; 11 males and 6 females with mean age of
64.2+7.1 years; 12 patients had basal cell carcinoma and 5 patients had squameous cell carcinoma
and 8 patients had associated morbidities. Surgical resection was performed with safety margin
adjusted according to intraoperative print cytology performed for all cases; fan flap was fashioned
so as to include the angle of the mouth as the pivot for flap rotation, upper labial advancement flap
was prepared for completion of closure of the resultant defect and cheek advancement flap was
fashioned for closure of the defect resulted after fan flap fashioning. All patients underwent
functional and aesthetic evaluation including the ability to whistle, blow the cheek and to suckle
the tube, and their satisfaction with the circumference of the mouth when fully opened and with
the commissural appearance.
Results: All patients had primary surgical excision and immediate repair. Operative data included
mean safety margin distance of 6.9+1.6 mm, mean resultant defect in relation to lip size was
56+6%, mean operative time was 146.2+18.8 min and mean operative blood loss was 266.5+49.7
cc. Five patients had postoperative (PO) surgery-related morbidities for a rate of 29.4%; 3 patients
had wound infection with small length wound dehiscence in one patient and 2 patients developed
microstomia. Mean PO follow-up period was 27.9+10.7 months. No cancer or surgery-related
mortalities were reported. Mean PO satisfaction score was 10.8+2.4; 5 patients had score <10,
while 12 patients had score >10.
Conclusion: lpsilateral fan with contralateral advancement flaps for upper lip reconstruction after
extensive resection for upper lip carcinoma and provide acceptable functional and aesthetic
outcome. |
