Minimizing Microstomia While Maximizing Esthetics in the Reconstruction of Acquired Lip Defects: The Evolution of the Bilateral Paramedian Cross-Lip Flap

摘要

Mutilating trauma and malignancy can create devastating lip defects. After insult or ablation, it is essential to strike a workable balance between esthetics and preservation of oral sphincter competence, which is fundamental for articulation, deglutition, and social and personal acceptance. Perioral local flaps are often the best source of combined vermilion, orbicularis oris, and mucosal reconstruction. Numerous techniques exist for reconstructing acquired lip defects including lateral and inferior cheek advancements, gate flaps, and fan techniques. However, such techniques often result in variable degrees of microstomia, which can handicap subsequent oral hygiene efforts as well as dental rehabilitation. We describe our experience with bilateral paramedian cross-lip flaps (BP-CLF) in 2 patients with subtotal lower lip defects after ablation of squamous cell carcinoma (SCC). The results reaffirm the importance of sphincter function and the advantages of the BPCLF compared with similar and traditionaltechniques.