Reconstruction of intraoral defects with superior labial artery musculo-mucosal flap: a preliminary clinical study

Year 2010, Volume: 20 Issue: 3, 118 - 122, 30.06.2010

Erdem Güven Alper Mete Uğurlu Karaca Başaran Salih Onur Basat Barış Yiğit Günter Hafız Samet Vasfi Kuvat

Abstract

Objectives: In this article, we present the use of the superior labial artery musculo-mucosal SLAMM flap for intraoral reconstruction. Patients and Methods: The study included five patients 2 females, 3 males; mean age 36 years; range 11 to 56 years who consulted at our clinic between October 2008 and January 2010. Five oral defects were reconstructed with the SLAMM flap. Three patients underwent reconstruction with SLAMM flap following oncologic resection. The other two patients had traumatic defects in the oral cavity which necessitated flap application. First, the distal end of the flap was incised and the superior labial artery was identified after dissection. After ligation of the artery, the mucosa, submucosa and the cuff of orbicularis oris muscle were elevated. The dissection was extended laterally and anteriorly, depending on the necessary flap size. Results: None of the patients had partial or total flap necrosis. During the follow-up period, contracture developed in only one patient. Successful reconstruction was observed in all patients. Conclusion: The superior labial artery musculo-mucosal flap is a simple and feasible technique which can be used for reconstruction of intraoral defects.

Keywords

Intraoral defect, musculo-mucosal flap, superior labial artery

Süperiyor labial arter muskulo-mukozal flep ile ağız içi defektlerinin rekonstrüksiyonu: Ön klinik çalışma

Abstract

Amaç: Bu makalede, ağız içi rekonstrüksiyonu için süperiyor labial arter muskulo-mukozal SLAMM flep kullanımı sunuldu.Hastalar ve Yöntemler: Ekim 2008 ve Ocak 2010 tarihleri arasında kliniğimizde konsültasyonu yapılan beş hasta 2 kadın, 3 erkek; ort. yaş 36 yıl; dağılım 11-56 yıl çalışmaya dahil edildi. Beş ağız içi defekti SLAMM flep ile yeniden yapılandırıldı. Onkolojik rezeksiyonu takiben üç hastaya SLAMM flep onarımı uygulandı. Diğer iki hastada ağız içinde flep uygulamasını gerektiren travmatik defektler bulunmaktaydı. Öncelikle, flep distal ucu insize edildi ve diseksiyon sonrasında süperiyor labial arter belirlendi. Arterin bağlanmasından sonra, mukoza, submukoza ve kısmi orbikularis oris kası kaldırıldı. Diseksiyon, flep büyüklük ihtiyacına göre, lateral ve anteriyora doğru genişletildi.Bulgular: Hiçbir hastada kısmi ya da tam flep nekrozu gözlenmedi. Takip süresince yanlızca bir hastada kontraktür gelişti. Tüm hastalarda başarılı rekonstrüksiyonun sağlandığı gözlendi.Sonuç: Süperiyor labial arter muskulo-mukozal flep, intraoral defektlerin rekonstrüksiyonunda, kolay ve uygun bir tekniktir

Keywords

Ağız içi defekti, muskulo-mukozal flep, süperiyor labial arter

References

• Bozola AR, Gasques JA, Carriquiry CE, Cardoso de Oliveira M. The buccinator musculomucosal flap: ana- tomic study and clinical application. Plast Reconstr Surg 1989;84:250-7.
• Pribaz J, Stephens W, Crespo L, Gifford G. A new intraoral flap: facial artery musculomucosal (FAMM) flap. Plast Reconstr Surg 1992;90:421-9.
• Pribaz JJ, Meara JG, Wright S, Smith JD, Stephens W, Breuing KH. Lip and vermilion reconstruction with the facial artery musculomucosal flap. Plast Reconstr Surg 2000;105:864-72.
• Gurunluoglu R. Composite skin-muscle-mucosal flap based on the superior labial artery for lower lip recon- struction. J Oral Maxillofac Surg 2007;65:1869-73.
• Dupoirieux L, Plane L, Gard C, Penneau M. Anatomical basis and results of the facial artery musculomucosal flap for oral reconstruction. Br J Oral Maxillofac Surg 1999;37:25-8.
• Ayad T, Kolb F, De Monés E, Mamelle G, Temam S. Reconstruction of floor of mouth defects by the facial artery musculo-mucosal flap following cancer abla- tion. Head Neck 2008;30:437-45.
• Baj A, Rocchetta D, Beltramini G, Giannì AB. FAMM flap reconstruction of the inferior lip vermilion: sur- gery during early infancy. J Plast Reconstr Aesthet Surg 2008;61:425-7.
• Hatoko M, Kuwahara M, Tanaka A, Yurugi S. Use of facial artery musculomucosal flap for closure of soft tissue defects of the mandibular vestibule. Int J Oral Maxillofac Surg 2002;31:210-1.
• Kashiwa K, Kobayashi S, Honda T, Kudo S, Kashiwaya G, Nasu W, et al. Orbicularis oris myomucosal island flap transfer to the nose. J Plast Reconstr Aesthet Surg 2009;62:e341-4.
• Nakajima H, Imanishi N, Aiso S. Facial artery in the upper lip and nose: anatomy and a clinical application. Plast Reconstr Surg 2002;109:855-61.
• Kuvat SV, Karakullukçu B, Hafiz G, Arinci A, Pilanci O, Aköz E. Head and neck reconstruction with dorso- radial forearm free flap: a preliminary clinical study. B-ENT 2009;5:259-63.
• Kuvat SV, Aydin A, Hafiz G, Aslan I, Hocağlu E, Biçer A, et al. Reconstruction of the head and neck with free osteoseptocutaneous flap in elderly heavy smokers. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2008;18:61-5.
• Mağden O, Edizer M, Atabey A, Tayfur V, Ergür I. Cadaveric study of the arterial anatomy of the upper lip. Plast Reconstr Surg 2004;114:355-9.
• Elliott RA Jr. Use of nasolabial skin flap to cover intraoral defects. Plast Reconstr Surg 1976;58:201-5.
• Fischinger J, Zargi M. Repair of anterior floor of mouth defects by a central or paramedian island tongue flap. J Laryngol Otol 2003;117:391-5.
• Robotti E, Righi B, Carminati M, Ortelli L, Bonfirraro PP, Devalle L, et al. Oral commissure reconstruction with orbicularis oris elastic musculomucosal flaps. J Plast Reconstr Aesthet Surg 2010;63:431-9.
• Millard DR Jr, McLaughlin CA. Abbe flap on mucosal pedicle. Ann Plast Surg 1979;3:544-8.