SMALL MYOCUTANEOUS MUCOSAL FLAP RECONSTRUCTION OF THE UPPER AND LOWER LIP AFTER EXCISION OF THE LOCALLY ADVANCED LIP MALIGNANCY

Document Type : Original Article

Authors

Surgical Oncology Unit and General Surgery Department, Faculty of Medicine, Mansoura University, Mansoura-Egypt

Abstract

Introduction: The carcinoma of the lip is always a squamous cell carcinoma, adequate excision of the malignancy was 
always accompanied by cure but with composite defects of skin and mucous membrane. We always need to combine 
reconstructive techniques to achieve the integrity of all layers. 
Patients and Methods: For thirty two patients of locally advanced lip malignancy, radical excision and reconstruction were achieved. For twenty four patients near total lower lip and sometimes total lower lip were removed and reconstruction of the lower lip was done using the depressor anguli oris myocutaneousmucosal flap (DAOMMF) and tongue flap. For four patients excision of the upper lip and part of the lower lip was reconstructed with depressor anguli oris myocutaneousmucosal flap (DAOMMF) with cheek advancement. For four patients excision of the upper lip only and reconstruction was done using the same flap but sometimes with tunneling technique. 
Results: Good results were achieved in 28 cases. Separation of the suture line has complicated one case, with repeated 
preoperative courses of radiotherapy. Partial necrosis of the flaps complicated two cases . Unaccepted hypertrophied scars with contracture deformity complicated one case only. 
Conclusion: Adequate excision and primary reconstruction, gives the best results for cure and cosmoses for management of the lower and upper lip malignancy. The combined techniques of reconstruction can solve the most complicated defects. 

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