The hybrid concept in lip reconstruction

Local tissues are best suited for lip reconstruction. The defect following cancer resection is often significant where standard methods are often suboptimal. Here we are presenting 3 such cases. Case 1, a 65 years old male post squamous cell carcinoma (SCC) resection with 50% defect of lower lip and a commissure, reconstructed with Estlander flap and a unilateral Karapandzik flap on opposite side. Case 2, a 35 years old male had a similar kind of defect, reconstructed with Estlander flap and step-plasty on opposite side. Case 3, a 70 years old female with 80% central lower lip defect post SCC resection, was reconstructed with bilateral Karapandzik flaps and an Abbe flap. Considering the significant size defect, all cases healed quite satisfactorily. They maintained their oral competence with negligent microstomia. The hybrid principle of combining various reconstructive techniques is highly recommended for major lip defects.

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Upper lip reconstruction post major cancer resections using the hybrid concept

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202535 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1347

Author(s):

Badr M. I. Abdulrauf

Keyword(s):

Cancer Surgery ◽

Central Unit ◽

Upper Lip ◽

Additional Advantage ◽

Lower Lip ◽

Lip Reconstruction ◽

Hybrid Concept ◽

Upper Lip Reconstruction ◽

Abbé Flap ◽

Standard Techniques

Major defects of the upper lip due to cancer surgery are relatively less common compared to lower lip. Standard techniques such as Karapandzic’s are capable of reconstructing up to fifty percent of the lip otherwise microstomia and oral incompetence may result. The upper lip has few aesthetic characteristic details due to the philtrum, its columns and cupid’s bows. Here we are proposing incorporation of an abbe flap to reconstruct the central unit of upper lip, associated with Karapandzic flaps from both sides. Use of a lip sharing concept has an additional advantage of producing harmony to the reconstructed region, and avoidance of crowding phenomena to the lower lip.

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Esthetic and Safe Lower Lip Reconstruction of an Asymmetric Defect Due to Cancer Resection: A Modified Webster Method Combined With a Nasolabial Flap

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2011.01.007 ◽

2011 ◽

Vol 69 (6) ◽

pp. e256-e259 ◽

Cited By ~ 3

Author(s):

Tomohiro Minagawa ◽

Taku Maeda ◽

Ryuta Shioya

Keyword(s):

Nasolabial Flap ◽

Lower Lip ◽

Lip Reconstruction ◽

Cancer Resection

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Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction

Case Reports in Medicine ◽

10.1155/2014/458286 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Theodoros Stathas ◽

Georgios Tsinias ◽

Dimitra Tsiliboti ◽

Aris Tsiros ◽

Nicholas Mastronikolis ◽

...

Keyword(s):

Free Flap ◽

Free Flaps ◽

Radial Forearm Flap ◽

Lower Lip ◽

Lip Reconstruction ◽

Forearm Flap ◽

Radial Forearm ◽

Lip Carcinoma ◽

The Aesthetic ◽

Lip Defect

Reconstruction after resection of large tumors of the lower lip requires the use of free flaps in order to restore the shape and the function of the lip, with the free radial forearm flap being the most popular. In this study we describe our experience in using the dorsalis pedis free flap as a salvage option in reconstruction of total lower lip defect in a patient with an extended lower lip carcinoma after failure of the radial forearm free flap, that was initially used. The flap was integrated excellently and on the followup the patient was free of disease and fully satisfied with the aesthetic and functional result.

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P.308 Lower lip reconstruction using the Abbe flap in a squamous cell carcinoma case

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/s1010-5182(06)60813-5 ◽

2006 ◽

Vol 34 ◽

pp. 210

Author(s):

R. Amaral Mendes ◽

S. Evelhoch

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Lower Lip ◽

Lip Reconstruction ◽

Squamous Cell Carcinoma Case ◽

Abbé Flap

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Chin IX: Unusual Soft Tissue Problems of the Lower Face

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0029-1224776 ◽

2009 ◽

Vol 2 (3-4) ◽

pp. 141-150 ◽

Cited By ~ 1

Author(s):

Roberto L. Flores ◽

Barry M. Zide

Keyword(s):

Soft Tissue ◽

Lower Lip ◽

Lip Reconstruction ◽

Lower Face ◽

Second Stage ◽

Aesthetic Unit ◽

Soft Tissue Problems ◽

Abbé Flap ◽

Reconstructive Methods

When the editor asked me to write something related to the chin, I (B.M.Z.) told him I would like to concentrate on the soft tissue of the perioral and chin region, something previously not presented before in this Journal specifically or anywhere. Dr. Flores and I have chosen certain soft tissue cases of the lower face, each of which presents certain dilemmas. The reconstructive methods in each case are unique, previously not shown, and represent salvage from prior failures. Case 1 shows how an interior Abbe flap can be used for ipsilateral lip reconstruction. Case 2 shows how a large upper lateral lip elemental loss can be regained from cheek and not the lower lip. Cases 3 and 4 show how to regain proper white roll bulge and symmetry by overcorrection, then exact adjustment in a second stage. Case 5 shows how a failed chin/lip reconstruction can be salvaged to regain sulcus height and aesthetic unit reconstruction. Each case depicts unique reconstructive designs to produce an aesthetic final result.

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Single-stage lower lip reconstruction with Estlander-Abbe flap over mouth angle

Toukeibu Gan ◽

10.5981/jjhnc.37.429 ◽

2011 ◽

Vol 37 (3) ◽

pp. 429-432

Author(s):

Makiko Sasaki ◽

Yumeji Takeichi ◽

Kazuhisa Yokoo ◽

Hiroyuki Tada ◽

Masaya Katou

Keyword(s):

Single Stage ◽

Lower Lip ◽

Lip Reconstruction ◽

Abbé Flap

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Reconstruction of a large lower lip defect using a combination of Abbe and staircase flaps: a case report

Archives of Craniofacial Surgery ◽

10.7181/acfs.2021.00493 ◽

2021 ◽

Vol 22 (6) ◽

pp. 324-328

Author(s):

Bo Min Moon ◽

Woo Sik Pae

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Wide Resection ◽

Large Defect ◽

Lower Lip ◽

Sphincter Function ◽

Abbé Flap ◽

Reconstruction Option ◽

Lip Defect

Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient’s oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

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