Reconstruction of Subtotal Defect of the Lower Lip: Combined Use of Karapandzic and Nasolabial Flap
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CLINICAL REPORT
Reconstruction of Subtotal Defect of the Lower Lip: Combined Use of Karapandzic and Nasolabial Flap Pradeep Pradhan1 • Abhijeet Kumar Mishra1 • Krishna Kinkar Das1 Aswathi Kallyadan Veetil1
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Received: 8 September 2020 / Accepted: 5 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Subtotal reconstruction of the lower lip after excision of the tumor is always a challenge for surgeons. It is because of the difficulty in regaining the function of the lip, including the oral competency and restoring the aesthetic subunit. A 46-year-old patient presented with an ulceroproliferative growth involving 70% of the lower lip, including the right commissure. After the confirmation to be a malignancy, patient underwent excision of the tumour and reconstruction of the lower lip using the left Karapandzic flap and right nasolabial flap. The patient was on regular follow-up in the postoperative period to assess the surgical outcomes. The combined use of Karapandzic flap and the nasolabial flap can be reliably used for subtotal reconstruction of the lower lip in advanced oral cavity malignancy, involving one of the commissures. Later can ensure good postoperative results in terms of aesthetic and functional lip reconstruction without any significant intraoperative or postoperative complications. Keywords Lip Karapandzic flap Nasolabial flap Outcomes
oral competency and restoring the aesthetic subunit [1, 2]. The challenge is, even more, when there is extensive involvement of tumour, especially to the angle of the mouth. Although smaller defects can be successfully repaired with primary suturing or local rotational flaps, a subtotal defect in the lower lip often requires a dependant flap like Karapandzic flap for satisfactory structural and functional outcomes. Despite the good postoperative results, Karapandzic flaps are inevitably associate with microstomia. Again, its utility gets limited when one of the commissures of the mouth gets involved by the tumour where the nasolabial flap can be an alternative surgical option to maintain the aesthetics of the lower lip with a good functional outcome. In such circumstances, the combined use of Karapandzic flap and nasolabial flaps can be an option to be used to reconstruct the subtotal defect in the lower lip. In this surgical report, the authors presented the effectiveness of dual flaps, i.e., Karapandzic and nasolabial flaps in the reconstruction of subtotal lower lip involving the angle of mouth in advanced oral cavity malignancy.
Case Report Introduction Subtotal reconstruction of the lower lip after excision of the tumor is always a challenge for surgeons. It is because of the difficulty of regaining the function of the lip, including the
& Pradeep Pradhan [email protected] 1
Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
A 46-year-old patient presented to the Department of Otorhinolaryngology with an ulceroproliferative growth involving the right lower lip
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