The commissure-based triangular flap for lip revision following reconstruction of a through-and-through defect

摘要

Management of lip deformities following free-flap reconstruction for head and neck cancer represents a particular challenge. Ideal restoration must provide not only mucosal lining and outer skin, but must also reestablish a labial sulcus and adequate oral sphincter function to prevent drooling.1'2 While commissure reconstruction can be attempted by vermillion advancement or other local flaps, the limitation of many of these approaches lies in the failure to create an adequate sulcus and provide for enough lower lip support.3 We therefore describe a novel technique for secondary commissuroplasty and lip revision using a commissure-based triangular flap and anterior z-plasty following anterolateral thigh free-flap reconstruction for a large perioral defect.