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013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect

Received: 5 December 2019     Accepted: 29 January 2020     Published: 10 February 2020
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Abstract

Through-and-through defect of soft tissues of the cheek, mouth angles, upper and lower lip originate from surgical intervention of tumors of the oral cavity involving external skin, soft tissue and oral lining. The article describes an original method of one-stage reconstruction in N. N. Blokhin National Medical and Research Center of Oncology. Russian Federation’s patent № 2489096 was granted for this method. We propose to use 3 different flaps from different anatomic areas, which have varying histological structures and independent blood supply. The first flap - muscle, is formed from the biggest part of the muscles masseter from the affected side and serves to restore the functions of the lips and cheek due to the fact that after the formation of the flap two its parts fixed to the remnants of the muscles of the upper and lower lips and part of the buccal muscle. The flap is perfusion by a. maxillaris and a. facialis. The second flap - musculocutaneous, formed from the skin of areas adjacent to the defect, nasolabial or submandibular. The flap serves to replace a skin defect, defect of the cheek, upper and lower lips. The flap is perfusion by a. facialis. The third flap - fascial, formed from the temporal fascia on the affected side. The temporal fascial flap is used to replace the defect of the mucous membrane of the cheek, upper and lower lips, in addition, the red border of the lips and the corner of the mouth. The flap is perfusion by aa. temporalis profunda et superficialis. All three flaps perfectly carry out hermetic sealing of the oral cavity, independent perfusion of each flap, even in the case of necrosis of one of the flaps, allows preservation of hermeticism. The use of three flaps with different histological structure allows to achieve a good functional and aesthetic result. Flaps perform various functions, ensuring the functional and anatomical usefulness of the resected tissues. By improving the blood suppling of flaps, we reduce time for patient’s rehabilitation and postoperative damage.

Published in Journal of Surgery (Volume 8, Issue 1)
DOI 10.11648/j.js.20200801.15
Page(s) 22-27
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Plastic, Replacement, Defect, Reconstruction, Flap

References
[1] Nerobeev A., Plotnikova N. Reconstructive surgery of the maxillofacial soft tissue region: A guidelines. Moscow: Medicine, 1997.
[2] Bernadsky Yu. I. Traumatology and reconstructive surgery of the craniofacial region. M: Medical literature, 2006.
[3] Chudakov O. P., Trizna N. M., Tesevich L. I. Options for compensating through defects in the quantum region using organotypic plastic material. Patent № a20040633. 07.07.2004.
[4] Durnovo E. A., Mishina N. V., Khomutinnikova N. E., et al. Plastic surgery of through-and-through defects of the maxillofacial region patients with cancer. Modern technologies in medicine 2010; 4: 86-91.
[5] Perlukhin M. L., Sulimov A. F., Akhmetyanov A. Sh. Elimination of defects in the maxillofacial region by using microsurgical autotransplants. Siberian journal of Oncology 2008; 1 (25): 106-7.
[6] Weerda H. Reconstructive facial plastic surgery. A problem-solving manual. Stuttgart – New-York, 2001. P. 4–6.
[7] Косметические операции лица /Под ред. Михельсона Н. М. - М., Медицина, 1962, С. 123-124.
[8] Wu, J. C.-H., Lee, Y.-C., Cheng, Y.-C., & Wu, C.-W. (2017). Reconstruction of Through-and-through Oromandibular Defect. Plastic and Reconstructive Surgery - Global Open, 5 (2), e1212.
[9] Jeng, S.-F., Kuo, Y.-R., Wei, F.-C., Su, C.-Y., & Chien, C.-Y. (2004). Reconstruction of Concomitant Lip and Cheek Through-and-Through Defects with Combined Free Flap and an Advancement Flap from the Remaining Lip. Plastic and Reconstructive Surgery, 113 (2), 491–498.
[10] Karapandzic, M. Reconstruction of lip defects by local arterial flaps. Br. J. Plast. Surg. 47: 422, 1994.
[11] Kroll, S. S. Staged sequential flap reconstruction for large lower lip defects. Plast. Reconstr. Surg. 88: 620, 1991.
[12] Liu WC, Yang KC. One-stage through-and-through cheek, lips, and oral commissure reconstruction using a double-paddle peroneal chimeric flap: an innovative method. Head Neck. 2015; 37 (5): 662–9.
[13] Ethunandan M, Macpherson DW, Santhanam V. Karapandzic flap for reconstruction of lip defects. J Oral Maxillofac Surg. 2007; 65 (12): 2512–7.
[14] Yamauchi M, Yotsuyanagi T, Ezoe K, Saito T, Yokoi K, Urushidate S. Estlander flap combined with an extended upper lip flap technique for large defects of lower lip with oral commissure. J Plast Reconstr Aesthet Surg. 2009; 62 (8): 997–1003.
[15] Sakakibara A, Matsumoto K, Hasegawa T, Minamikawa T, Komori T. Single-stage reconstruction for buccal mucosa tumor resection including the labial commissure using a facial artery musculomucosal flap and a vermilion advancement flap. J Surg Case Rep. 2017; 20 (6): rjx108.
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  • APA Style

    Igor Zaderenko, Ali Mudunov, Sergey Ivanov, Sevil Alieva, Vasiliy Tsiklauri, et al. (2020). 013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect. Journal of Surgery, 8(1), 22-27. https://doi.org/10.11648/j.js.20200801.15

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    ACS Style

    Igor Zaderenko; Ali Mudunov; Sergey Ivanov; Sevil Alieva; Vasiliy Tsiklauri, et al. 013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect. J. Surg. 2020, 8(1), 22-27. doi: 10.11648/j.js.20200801.15

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    AMA Style

    Igor Zaderenko, Ali Mudunov, Sergey Ivanov, Sevil Alieva, Vasiliy Tsiklauri, et al. 013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect. J Surg. 2020;8(1):22-27. doi: 10.11648/j.js.20200801.15

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  • @article{10.11648/j.js.20200801.15,
      author = {Igor Zaderenko and Ali Mudunov and Sergey Ivanov and Sevil Alieva and Vasiliy Tsiklauri and Alexander Kazimov and David Safarov and Alexandra Eremina and Alena Hromushina and Bulat Bektimirov and Alexander Dymnikov},
      title = {013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect},
      journal = {Journal of Surgery},
      volume = {8},
      number = {1},
      pages = {22-27},
      doi = {10.11648/j.js.20200801.15},
      url = {https://doi.org/10.11648/j.js.20200801.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.15},
      abstract = {Through-and-through defect of soft tissues of the cheek, mouth angles, upper and lower lip originate from surgical intervention of tumors of the oral cavity involving external skin, soft tissue and oral lining. The article describes an original method of one-stage reconstruction in N. N. Blokhin National Medical and Research Center of Oncology. Russian Federation’s patent № 2489096 was granted for this method. We propose to use 3 different flaps from different anatomic areas, which have varying histological structures and independent blood supply. The first flap - muscle, is formed from the biggest part of the muscles masseter from the affected side and serves to restore the functions of the lips and cheek due to the fact that after the formation of the flap two its parts fixed to the remnants of the muscles of the upper and lower lips and part of the buccal muscle. The flap is perfusion by a. maxillaris and a. facialis. The second flap - musculocutaneous, formed from the skin of areas adjacent to the defect, nasolabial or submandibular. The flap serves to replace a skin defect, defect of the cheek, upper and lower lips. The flap is perfusion by a. facialis. The third flap - fascial, formed from the temporal fascia on the affected side. The temporal fascial flap is used to replace the defect of the mucous membrane of the cheek, upper and lower lips, in addition, the red border of the lips and the corner of the mouth. The flap is perfusion by aa. temporalis profunda et superficialis. All three flaps perfectly carry out hermetic sealing of the oral cavity, independent perfusion of each flap, even in the case of necrosis of one of the flaps, allows preservation of hermeticism. The use of three flaps with different histological structure allows to achieve a good functional and aesthetic result. Flaps perform various functions, ensuring the functional and anatomical usefulness of the resected tissues. By improving the blood suppling of flaps, we reduce time for patient’s rehabilitation and postoperative damage.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - 013Novel Method of Substitution for Combine Through-and-through Angle of the Mouth, Fragments of Upper and Lower Lips Defect
    AU  - Igor Zaderenko
    AU  - Ali Mudunov
    AU  - Sergey Ivanov
    AU  - Sevil Alieva
    AU  - Vasiliy Tsiklauri
    AU  - Alexander Kazimov
    AU  - David Safarov
    AU  - Alexandra Eremina
    AU  - Alena Hromushina
    AU  - Bulat Bektimirov
    AU  - Alexander Dymnikov
    Y1  - 2020/02/10
    PY  - 2020
    N1  - https://doi.org/10.11648/j.js.20200801.15
    DO  - 10.11648/j.js.20200801.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 22
    EP  - 27
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20200801.15
    AB  - Through-and-through defect of soft tissues of the cheek, mouth angles, upper and lower lip originate from surgical intervention of tumors of the oral cavity involving external skin, soft tissue and oral lining. The article describes an original method of one-stage reconstruction in N. N. Blokhin National Medical and Research Center of Oncology. Russian Federation’s patent № 2489096 was granted for this method. We propose to use 3 different flaps from different anatomic areas, which have varying histological structures and independent blood supply. The first flap - muscle, is formed from the biggest part of the muscles masseter from the affected side and serves to restore the functions of the lips and cheek due to the fact that after the formation of the flap two its parts fixed to the remnants of the muscles of the upper and lower lips and part of the buccal muscle. The flap is perfusion by a. maxillaris and a. facialis. The second flap - musculocutaneous, formed from the skin of areas adjacent to the defect, nasolabial or submandibular. The flap serves to replace a skin defect, defect of the cheek, upper and lower lips. The flap is perfusion by a. facialis. The third flap - fascial, formed from the temporal fascia on the affected side. The temporal fascial flap is used to replace the defect of the mucous membrane of the cheek, upper and lower lips, in addition, the red border of the lips and the corner of the mouth. The flap is perfusion by aa. temporalis profunda et superficialis. All three flaps perfectly carry out hermetic sealing of the oral cavity, independent perfusion of each flap, even in the case of necrosis of one of the flaps, allows preservation of hermeticism. The use of three flaps with different histological structure allows to achieve a good functional and aesthetic result. Flaps perform various functions, ensuring the functional and anatomical usefulness of the resected tissues. By improving the blood suppling of flaps, we reduce time for patient’s rehabilitation and postoperative damage.
    VL  - 8
    IS  - 1
    ER  - 

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Author Information
  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Maxillo-facial Surgery and Operative Dentistry, Peoples Friendship University of Russia, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Maxillo-facial Surgery and Operative Dentistry, Peoples Friendship University of Russia, Moscow, Russia

  • Department of Maxillo-facial Surgery and Operative Dentistry, Peoples Friendship University of Russia, Moscow, Russia

  • Department of Oncology and Surgical Treatment (Head and Neck Tumors), Federal State Budgetary Institution ?N. N. Blokhin National Medical and Research Center of Oncology? of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

  • Department of Maxillo-facial Surgery and Operative Dentistry, Peoples Friendship University of Russia, Moscow, Russia

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