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At least 415 records · Page 23Linked to original sources
PubMed2005

Cutaneous lip tumours treated with Mohs micrographic surgery: clinical features and surgical outcome.

BACKGROUND: The Australian Mohs micrographic surgery (MMS) database was initiated in 1993 by the Skin and Cancer Foundation Australia (SCFA) with the aim of collecting prospective data, and involved all Mohs surgeons in the country. OBJECTIVES: To present a large series of patients with cutaneous lip tumours treated with MMS in Australia between 1993 and 2002. METHODS: This prospective multicentre case series included all patients with cutaneous lip tumours who were monitored by the SCFA. The main outcome measures were patient demographics, reason for referral, duration of tumour, site, preoperative tumour size and postoperative defect size, recurrences prior to MMS, histological subtypes, perineural invasion and 5-year recurrence after MMS. RESULTS: There were 581 patients (66.1% women and 33.9% men, P < 0.0001) with a mean +/- SD age of 58 +/- 15 years. The upper lip was the most common site involved (81.1%). Basal cell carcinoma (BCC) was diagnosed in 82.3%, squamous cell carcinoma (SCC) in 16.5%, Bowen's disease (BD) in 0.7% and microcystic adnexal carcinoma (MAC) in 0.5% of cases. BCC was more common on the upper lip and in women, whereas SCC was more common on the lower lip and in men (P < 0.0001). Most upper lip tumours occurred in women (75.4%), whereas most lower lip tumours occurred in men (73.6%). SCC was associated with a larger tumour and postoperative defect size compared with the other tumours. The 5-year recurrence for BCC was 3.0%, and there were no cases of recurrence for SCC, BD or MAC. CONCLUSIONS: BCC was the most common cutaneous lip tumour managed by MMS, and was significantly more common on the upper lip and in women. The low 5-year recurrence rate emphasizes the importance of margin-controlled excision.

Adult↗
PubMed2006

Autologous melanocyte transfer via epidermal grafts for lip vitiligo.

BACKGROUND: Vitiligo of the lips is a common concern of great psychologic consequence. Medical therapies are often ineffective due mainly to the absence of hair follicles. The transfer of melanocytes or melanocyte-bearing skin by a surgical procedure may repigment this condition. Only a few surgical modalities have been successful in this "difficult to treat" site. OBJECTIVE: To assess the effectiveness of autologous melanocyte transfer by epidermal grafts for lip vitiligo and to review the literature on the surgical correction of lip vitiligo. METHODS: Twenty-six vitiligo patients (20 women and six men; age range, 13-43 years; mean, 26.8 years) having 31 affected lips with stable disease were included in the study. The suction blisters were raised using our own modified device on the lateral aspect of the thigh. The roofs of the blisters were transferred to the dermabraded recipient area. The dressing, together with the grafts, was removed on day 8. Patients were given photochemotherapy for 6 weeks. In addition, meta-analysis of the published literature on the surgical management of lip vitiligo was also performed. RESULTS: Complete repigmentation was observed in 27 of the 31 lip areas (87%) in 23 of 25 patients (92%) in whom a follow-up for 6 months or more was available. Complications observed were persistent hyperpigmentation in 12 lips and reactivation of herpes in one patient. Minimal hyperpigmentation was seen in most of the remaining lips. The results of the meta-analysis revealed that the success rate varies from 32.5% to 100% with various surgical procedures. CONCLUSION: Autologous melanocyte transfer is an effective and safe therapeutic option for stable vitiligo of the lips. It is cosmetically more acceptable, as there is no abnormal keratinization, which is a problem associated with dermo-epidermal grafts.

Adolescent↗
PubMed2005

Characterization of mast cell subpopulations in lip cancer.

BACKGROUND: Lip squamous cell carcinoma (SCC) is the most common form of oral cancer. Human mast cells (MCs), which are increased in lip SCC, are classified by their protease content in tryptase-positive (MC(T)) and tryptase/chymase-positive (MC(TC)). MC proteases are associated with tumor progression and angiogenesis. The aim of this study was to quantify and characterize MC subpopulations in lip SCC. METHODS: Serial sections from lip SCC (n = 21) and normal lip vermilion (n = 8) biopsies were stained immunohistochemically for tryptase and enzymehistochemically for chymase to determine MC subpopulation density and distribution. RESULTS: MC(T) and MC(TC) were increased in lip SCC when compared with normal lip (P < 0.0001), where MC(T) predominated over MC(TC) (P < 0.01). In lip SCC neither subpopulation predominated. Regarding distribution, MC(T) were higher than MC(TC) at the intratumoral stroma, whereas MC(TC) were higher than MC(T) at the peritumoral stroma (P < 0.01). CONCLUSIONS: The results suggest that MC subpopulations may contribute to lip SCC progression. While intratumoral MC(T) may stimulate angiogenesis, peritumoral MC(TC) may promote extracellular matrix degradation and tumor progression at the invasion front.

Adult↗
PubMed1984

Control of complex motor gestures: orofacial muscle responses to load perturbations of lip during speech.

The contribution of ascending afferents to the control of speech movement was evaluated by applying unanticipated loads to the lower lip during the generation of combined upper lip-lower lip speech gestures. To eliminate potential contamination due to anticipation or adaptation, loads were applied randomly on only 10-15% of the trials. Physical characteristics of the perturbations were within the normal range of forces and movements involved in natural lip actions for speech. Compensatory responses in multiple facial muscles and lip movements were observed the first time a load was introduced, and achievement of the multimovement speech goals was never disrupted by these perturbations. Muscle responses were seen in the lower lip muscles, implicating corrective, feedback processes. Additionally, compensatory responses to these lower lip loads were also observed in the independently controlled muscles of the upper lip, reflecting the parallel operation of open-loop, sensorimotor mechanisms. Compensatory responses from both the upper and lower lip muscles were observed with small (1 mm) as well as large (15 mm) perturbations. The latencies of these compensatory responses were not discernible by conventional ensemble averaging. Moreover, responses at latencies of lower brain stem-mediated reflexes (i.e., 10-18 ms) were not apparent with inspection of individual records. Response latencies were determined on individual loaded trials through the use of a computer algorithm that took into account the variability of electromyograms (EMG) among the control trials. These latency measures confirmed the absence of brain stem-mediated responses and yielded response latencies that ranged from 22 to 75 ms. Response latencies appeared to be influenced by the time relation between load onset and the initiation of muscle activation. Examination of muscle activity changes for individual loaded trials revealed complementary variations in the magnitude of responses among multiple muscles contributing to a movement compensation. These observations may have implications for limb movement control if multimovement speech gestures are considered analogous to a limb action requiring coordinated movements around multiple joints. In this context, these speech motor control data might be interpreted to suggest that for complex movements, both corrective feedback and open-loop predictive processes are operating, with the latter involved in the control of coordination among multiple movement subcomponents.

Electromyography↗
PubMed2005

Study of viridans streptococci and Staphylococcus species in cleft lip and palate patients before and after surgery.

OBJECTIVE: To determine the effect of surgery on types and colony count of Streptococcus and Staphylococcus species in cleft lip and palate (CLP) patients. DESIGN: Saliva samples were collected after the morning meal by placing a sterile cotton swab in the vestibule of the oral cavity from cleft lip and palate patients immediately preoperative and 12 weeks postoperative. Normal children were examined as a control group. Samples were cultured; Staphylococcus and Streptococcus isolates were identified and quantified. PATIENTS: Fifteen cleft lip and palate patients and 22 normal children, aged 3 to 39 months were examined. RESULTS: Streptococcus mitis biovar 1, Streptococcus salivarius and Streptococcus oralis of the viridans group of streptococci were the most commonly found in normal children, as well as in cleft lip and palate children. In the cleft lip and palate group, mean streptococcal count was 32.41 (29.80) and 46.46 (42.80) in the pre- and postoperative periods, respectively; in the normal group, the count was 20.93 (27.93) and 49.92 (34.72) at 0 week and 12 weeks, respectively. Staphylococcus aureus was the most common Staphylococcus species found in CLP patients, representing 47.4% postoperatively. In the cleft lip and palate children, mean staphylococcal count was 5.34 (8.13) and 0.56 (0.92) in the pre- and postoperative periods, respectively; in normal children, the count was 0.82 (1.98) and 0.60 (2.55) at 0 and 12 weeks, respectively. The differences were statistically significant only for the staphylococcal count between pre- and postoperative periods in children with cleft lip and palate as tested by analysis of variance (p < .05). CONCLUSIONS: Cleft lip and palate patients had more colonization by S. aureus compared with normal children, and the colony count decreased significantly following surgical repair of the cleft lip and palate.

Analysis of Variance↗
PubMed1998

Conversational skills of preschool and school-age children with cleft lip and palate.

OBJECTIVE: The purpose of this study was to examine the conversational skills of preschool and school-age children with cleft lip and palate. DESIGN: The children were audio- and videotaped during interactions with an unfamiliar adult. In addition, standardized measures of speech and language were administered, and ratings of resonance were obtained. Comparisons were made between the children with cleft lip and palate and their same-age peers on measures of conversational participation and a standardized test of pragmatic skills. PARTICIPANTS: Participants were 20 children with unilateral cleft lip and palate (10 preschoolers and 10 school-age children) recruited from the Craniofacial Team at Rainbow Babies and Children's Hospital, Cleveland (OH) and 20 noncleft peers matched for gender, age, and socioeconomic status. MAIN OUTCOME MEASURES: Separate comparisons were made for the preschool children with cleft lip and palate and their noncleft peers, and the school-age children with cleft lip and palate and their noncleft peers on eight measures of conversational assertiveness/responsiveness and the standardized tests of pragmatics. Next, each child with cleft lip and palate was classified for level of conversational participation. RESULTS: Paired t tests revealed no significant differences between the preschool and school-age children with cleft lip and palate and their noncleft peers in level of conversational participation. However, individual child comparisons revealed less assertive profiles of conversational participation for 50% of the preschool and 20% of the school-age children with cleft lip and palate. CONCLUSIONS: Children with cleft lip and palate may show a less assertive style of conversational participation, at least during the preschool years. Therefore, craniofacial team evaluations should include examination of conversational competency, particularly for children who are demonstrating difficulty with other aspects of speech, language, or social development.

Child↗
PubMedDate not supplied

Growth impairment of children with different types of lip and palate clefts in the first 2 years of life: a cross-sectional study.

OBJECTIVE: To analyze the differences in growth impairment according to sex in the 2 first years of life in children with three types of clefts. METHODS: This was a cross-sectional study of 881 children (58.9% boys and 41.1% girls) with cleft lip and palate treated at the Craniofacial Anomaly Rehabilitation Hospital, (University of São Paulo, Bauru, SP), Brazil. Age ranged from 1 to 24 months. Three types of clefts were evaluated: isolated cleft lip (181/20.5%), isolated cleft palate (157/17.8%) and cleft lip + palate (543/61.6%). Weight and length measurements and data regarding breast-feeding and socioeconomic level were obtained. Children with weight and length below the 10th percentile of the NCHS reference were considered to have impaired growth. RESULTS: Sample distribution according to cleft type and sex was similar to that observed in other epidemiological studies. Breast-feeding was more frequent in the isolated cleft lip group (45.9%) then in the isolated cleft palate (12.1%) or cleft lip + palate group (10.5%). Isolated cleft lip children showed less marked impairment of weight (23.8%) and length (19.3%) compared to the cleft lip + palate group (35.7% and 33.1%, respectively). In the latter group, the proportion of children with weight and length below the 10th percentile was very close to that of the isolated cleft palate group (34.4% and 38.9%). CONCLUSIONS: The impairment in weight and length was more severe in cleft lip + palate and isolated cleft palate children and may be attributed to feeding difficulties compared to the isolated cleft lip group.

Body Height↗
PubMed1996

Lip form responses to changes in maxillary incisor position.

A study was conducted to assess the measurement accuracy of a laser three-dimensional measurement system for measuring facial profile and to investigate the changes in lower facial morphology caused by experimental protrusion of the upper incisors, and also to examine the relationship between the changes in lip form and lip thickness. The study subjects were 24 Japanese male dental students attending Nihon University School of Dentistry at Matsudo, who had normal overbite, overjet, and normal occlusion, and a good facial profile. The mean age was 23.2 years with a range of 21.5 to 25.8 years. Three-dimensional measurements obtained by a computerized 3D laser scanning system were used to evaluate facial morphology. The measurement error of this system was less than 0.5 mm in any three-dimensional linear measurements. The stability and reproducibility of the recording procedure were evaluated. The changes in facial morphology caused by orthodontic treatment and orthognathic surgery were visualized in any direction by this three-dimensional graphic system. Lip thickness was not associated with changes in lip form. However, a relationship between the right and left corners of lip and lip thickness was noted. With regard to the ratio of changes in hard tissue and lips, the value of the original position for a 4 mm protrusion was not the same as that for a 4-8 mm protrusion. Also, the correlation of the changes in both groups was very low. The changes in lip thickness were associated with changes in stomion position, which in turn were related to the vertical change in the upper lip.

Adult↗
PubMed1995

Lip function in subjects with upper motor neuron type dysarthria following cerebrovascular accidents.

The lip function of 16 speakers with upper motor neuron damage following cerebrovascular accident (CVA), was investigated using instrumental measures. Sixteen, non-neurologically impaired adults matched for age and sex served as controls. The results of the instrumental investigations revealed that the CVA speakers had patterns of lip function that were significantly different from the control speakers. Specifically, on maximum force tasks, the CVA speakers were found to produce significantly lower maximum lip force values. Maximum rate of attempts at lip movement was also slower in the CVA speakers. In addition, the instrumental investigation revealed that the CVA speakers demonstrated a significant decline in pressure over the course of the task involving 10 attempts at maximum lip force. In contrast, the control speakers maintained a consistent level of force throughout the 10 repetitions/attempts. Overall, the findings suggest that the CVA speakers have deficits in maximum lip force, endurance of lip strength and rate of lip movements. Correlations conducted between instrumental measures of maximum lip strength and the perceptual ratings of overall intelligibility, precision of consonants, precision of vowels and length of phonemes revealed no significant relationship.

Aged↗
PubMed1999

[Cleft lip repair using a lateral columellar flap].

OBJECTIVE: Since the important cosmetic structures of a good looking lip, viz. the philtrum column, philtrum dimple and Cupid's bow of a cleft lip repaired with the commonly used methods, are still defective in various degrees, a new method is designed. METHODS: On the medial side of the cleft, the short philtrum is lengthened and the upwardly displaced Cupid's bow maintained in a lowered position by a rectangular flap transplanted from the lateral surface of the columella. No lip flap has been formed on the lateral side of the cleft. RESULTS: In a period of three years (1996-1998), 23 cases of unilateral cleft lip, 9 cases of bilateral cleft lip and 14 cases of secondary deformities of cleft lip have been repaired with this new method. All of the repaired lips have normal looking philtrum column (limited by an uninterrupted straight-line scar), philtrum dimple and Cupid's bow. CONCLUSION: The lateral columellar flap method is a more rational surgical procedure for cleft lip repair in that it repairs tissue defect by transplanting tissue from the unexposed area. The appearance of the repaired lip is better than that of the commonly used methods.

Cleft Lip↗
PubMed2004

[Electromyography study on complete bilateral cleft lip after reparation.].

PURPOSE: This study was undertaken to evaluate the motion effect of complete bilateral cleft lips objectively using electromyography. METHODS: 45 patients of complete bilateral cleft lips after operations several years which included 20 patients repaired using orbicularis oris muscle restoring functional method and 25 patients using straight line suture method were examined with electromyography (EMG) in prolabium, right and left lateral lips respectively. The most potential in every area of each patient at the maximal lip contraction position was measured and the values of two different method groups were subject to statistical analysis. RESULTS: The prolabium and lateral lips of both groups had no electric activity at posture position. At maximal contraction position, the mean potential of prolabium of orbicularis oris muscle restoring method group had no difference with the lateral lips. But the mean potential of prolabium of straight line suture method group was lower than that of the lateral lips significantly,also,it was lower than the potential of prolabium in the muscle functional reparation group. CONCLUSIONS: The reparation method of restoring orbicularis oris muscle to complete bilateral cleft lips was better than the straight line suture method in the motion effect. These findings suggest the superiority and necessity of functional muscle reparation for complete bilateral cleft lips.

Cleft Lip↗
PubMed2006

[Bernard-Soltan technique in surgical treatment of lower lip cancer].

UNLABELLED: In Poland lower lip cancer accounts for 0.7% all malignant tumours: 1.3% in men and 0.3% in women. In tumours involving more than 1/3 of the lip resection with simultaneous reconstruction is necessary. Recommended methods include Bernard technique modified by Soltan, Webster technique, and Karapandzic technique. The aim of the study was outcome evaluation of surgical treatment of lower lip cancer, particularly as a result of Bernard procedure modified by Soltan. MATERIAL AND METHODS: 60 patients underwent surgical treatment for lower lip cancer between 1994 and 1998. In 25 patients resection with simultaneous lower lip reconstruction was made using Bernard technique modified by Soltan. Of them, 20 patients were followed-up. Sex, age, place of living, clinical TNM stage, pathology report and resection radicality, recurrence after radiotherapy, wound healing and cosmetic and functional results of surgery were analysed. RESULTS: Lower lip cancer involving more than 1/3 of the lip was found in 38.8% men and 44.5% women. Among 25 patients operated using Bernard-Soltan technique, 40% were aged between 70 and 80 years. Twenty (80%) patients were country dwellers. In 60 patients' group there were 35 (58.33%) with TNM stage I, 56 (93.3%) cases of squamous spine cell carcinoma G1. In all 60 patients radicality was achieved. In 10 patients (16.7%) local recurrence after radiotherapy was treated with surgery. Wound suppuration was seen in 3 (12%) patients operated using Bernard-Soltan technique and in 1 case (4%) lobe necrosis with salivary fistula also occurred. In long-term follow-up lip sensation disorders were reported by 5 patients (mild in 3 cases--18.75% and significant in 2 cases--12.5%), speech disorders by 5 patients (mild in 4 cases--25% and significant in 1 case--6.25%). Saliva leakage was observed in 4 patients (mild in 3 cases--18.75% and significant in 1 case--6.25%). Cosmetic result was very good in 8 patients (50%), good in 6 patients (37.5%) and poor in 2 patients (12.5%). CONCLUSION: In locally advanced lower lip cancers surgical treatment using Bernard-Soltan technique results in good both early and long-term cosmetic and functional outcomes as well as a good oncological radicality.

Aged↗
PubMed2006

[Study on repair approach of bilateral cleft lips and nose deformity].

OBJECTIVE: To detect the operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip. METHODS: From March 2003 to December 2004, 26 patients with bilateral cleft lip were treated, aged 10 months to 11 years. Of 26 patients, there were 13 bilateral complete cleft lip and palate, 9 bilateral incomplete cleft lip and 4 mixed cleft lip with unilateral complete cleft palate. The chief design principle was keeping the length of prolabium. During operation, sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures. The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap and simultaneous simple rhinoplasty was performed. RESULTS: Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up, the results were satisfactory in the width and chubbiness of the nose bottom, the shapes of nostril and Cuspid's bow were good without whistle deformity. The appearance of upper lip was good in either dynamic or static state. CONCLUSION: Excellent shapes and function of the nose and lip, and opportunity for two-stage repair could be obtained with this method, which being believed important methods for the primary repair of bilateral cleft lip.

Child↗
PubMed1994

The occurrence of hypodontia in patients with cleft lip and/or palate.

The frequency of hypodontia (but for the third molar) was studied in a series of 600 patients with cleft lip and/or palate. The series was subdivided into three groups according to the type of facial cleft. As compared to the general normal population the occurrence of hypodontia was markedly increased in patients with clefts. The highest percentage of hypodontia was recorded in patients with cleft lip and palate, the lowest frequency was present in cleft lip only. In cleft lip and in cleft lip and palate girls were affected significantly more frequently than boys. The occurrence of hypodontia in the lower and in the upper jaw differed according to the type of cleft. The upper jaw was affected more often in cleft lip and in cleft lip and palate, the mandible was involved more frequently in isolated cleft palate. The dental bud of the upper lateral incisor was affected most commonly in cleft lip and in cleft lip and palate, while the second lower premolar was most frequently absent in isolated cleft palate.

Adolescent↗
PubMed2000

Lip and vermilion reconstruction with the facial artery musculomucosal flap.

The lips are a complex laminated structure. When lost through injury or disease, they present a complex reconstructive challenge. The facial artery musculomucosal (FAMM) flap is a composite flap with features similar to those of lip tissue. In this article, the anatomy, dissection, and clinical applications for the use of the FAMM flap in lip and vermilion reconstruction are discussed. A series of 16 FAMM flaps in 13 patients is presented. Seven patients had upper-lip reconstruction and six had lower-lip reconstruction. Superiorly based FAMM flaps were used in eight patients, and eight inferiorly based flaps were performed in five patients. Three patients had bilateral, inferiorly based flaps. In summary, the FAMM flap is a local flap that can be used for lip and vermilion reconstruction. Although not identical to the lip, it has many similar features, which make it an excellent option for lip reconstruction.

Adolescent↗
PubMed1990

Antibodies to meningococcal H.8 (Lip) antigen fail to show bactericidal activity.

Purified H.8 (Lip) antigen was coupled to tresyl-activated Sepharose 4B and used in affinity columns to purify anti-Lip antibodies from convalescent patient sera and from immune rabbit sera. Affinity-purified anti-Lip antibodies isolated from two convalescent patient sera contained 1000 and 1280 ELISA units of antibody and included antibodies of IgG, IgA, and IgM isotypes. An anti-Lip mouse monoclonal ascites (2-1-CA2) had 28,400 ELISA units of antibody. Bactericidal assays were performed using three different case strains of Neisseria meningitidis group B, namely 44/76, 8532, and 8047. Neither preparation of purified human anti-Lip antibodies had detectable bactericidal activity against strains 44/76 and 8532, but one of the two had a titer of 1:4 against strain 8047. Anti-Lip antibodies that were purified from immune rabbit serum and contained 1600 ELISA units of anti-Lip antibodies also failed to show detectable bactericidal activity. The rabbits were immunized with purified Lip antigen and showed specific antibody levels of 2000-2200 units by ELISA, but even the unfractionated sera had little or no bactericidal activity against the test strains. The high titer mouse monoclonal ascites had no bactericidal activity against the test strains. The poor bactericidal activity associated with monoclonal and polyclonal antibodies to the Lip antigen suggest that in spite of other attractive properties it may not be useful as a meningococcal vaccine.

Animals↗
PubMedDate not supplied

Functional lower lip reconstruction with bilateral cheek advancement flaps: revisitation of Webster method with a minor modification in the technique.

Major defects of the lower lip have been repaired in many ways. Of these, some employed flaps from the chin, cheek or upper lip. Some of these procedures employed flaps without regard for the facial grooves or landmarks. Some methods required incisions through nerves supplying the orbicularis oris and the flaps used for the lower lip reconstruction. Of the many methods of reconstruction that have been reported, we believe that the Webster technique should be considered as the first choice for lower lip defects larger than 80% of the total. Because this technique interferes minimally with the sensation of the lower lip and a satisfactory cosmetic outcome with a functional lower lip is achieved, the sensation and muscle function of the upper lip are unaffected. In addition to discussing the advantages of the Webster method, in this paper we present a minor modification in the dissection of the orbicularis oris muscle in an attempt to improve the motor innervation and to provide adequate oral competence and labial functioning in expression and speaking. Motor function and innervation of the lips after reconstruction was documented by clinical findings as well as electrophysiological methods.

Aged↗
PubMed2006

Composite anterolateral thigh-fascia lata flap: a good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction.

BACKGROUND: Major defects of the lower lip are challenging to the reconstructive surgeon. The major goals in treating total lower lip defects are reconstruction of the external skin and mucosal lining and maintenance of oral competence and sphincter function. The authors describe reconstruction of total lower lip and larger full-thickness defects including the cheek and commissure by means of a composite anterolateral thigh-fascia lata free flap. METHODS: The flap was harvested with 5-cm fascial extensions at the superior and inferior margins. The flap was folded over the fascia lata to restore the intraoral lining and cover the external skin defect. Fascia lata extensions were divided longitudinally into two fascial strips at both margins of the flap. Two strips were tunneled through the orbicularis muscle in the upper lip and sutured to each other and to the orbicularis muscle. The remaining two strips were anchored to the zygomatic bone periosteum by permanent sutures. This procedure was used in 11 patients. RESULTS: In all cases, disease was advanced squamosus cell carcinoma. The patients' ages ranged from 37 to 72 years. Nine patients had cancer of the lower lip and two patients had a buccal cancer involving the lip. The entire lower lip, bilateral modiolus, and part of the cheek were resected in all patients, and mandibulectomy was performed in three patients. Flap survival was 100 percent. One patient died 10 days after the operation because of cardiopulmonary arrest. At the end of the 1-year follow-up period, all patients had good oral continence at rest and had achieved sufficient oral competence when eating. Eight patients were able to resume a regular diet and two patients could eat a soft diet. CONCLUSIONS: This flap is a good choice for reconstruction of the extensive head and neck defects. We think that anterolateral thigh-fascia lata composite flap has maximum reconstructive capacity and minimal donor-site morbidity. This flap has many advantages over the radial forearm flap and should replace to the composite radial forearm palmaris longus tendon flap when total lower lip reconstruction is concerned.

Adult↗