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Head & Face Medicine
Published in: Head & Face Medicine 1/2019

Open Access 01-12-2019 | Research

Comparison of the reconstruction of through-and-through cheek defects involving the labial commissure following tumor resection using four types of local and pedicle flaps

Authors: Wei-liang Chen, Yan Wang, Bin Zhou, Juan-kun Liao, Rui Chen

Published in: Head & Face Medicine | Issue 1/2019

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Abstract

Background

The reconstruction of through-and-through cheek defects involving the labial commissure following cancer ablation is a surgical challenge.

Methods

This study evaluated 35 patients with buccal squamous cell carcinoma (SCC) involving the labial commissure who underwent Abbe–Estlander (A-EF), folded extended supraclavicular fasciocutaneous island (SFIF), folded pectoralis major muscle (PMMF), or folded extended vertical lower trapezius island myocutaneous (TIMF) flap reconstruction of through-and-through cheek defects involving the labial commissure following radical resection.

Results

The A-EF and SFIF groups differed significantly (P < 0.05) from the PMMF and TIMF groups in terms of tumor clinical stage and type of treatment. The inner PMMF (median 6.3 × 4.5) and TIMF (median 9.8 × 6.7) skin paddle dimensions were larger than those of the A-EF (median 1.8 × 2.2) and SFIF (median 5.5 × 4.3) groups (P < 0.05). The outer PMMF (median 6.3 × 6.6) and TIMF (median 9.8 × 13.2) dimensions were larger than those of the A-EF (median 1.8 × 3.8) and SFIF (median 5.5 × 4.6) groups (P < 0.05). The esthetic results, orbicularis oris function, and speech function were significantly (P < 0.05) better in the A-EF group than in the SFIF, PMMF, and TIMF groups. The patients were followed for 6–38 months (median 26.8, 25.0, 22.1, and 20.8 months in the A-EF, SFIF, PMMF, and TIMF groups, respectively). At the final follow-up, 4 (80.0%) patients in the A-EF, 7 (87.5%) in the SFIF, 5 (55.6%) in the PMMF, and 5 (38.4%) in the TIMF groups were alive with no disease; 1 (20.0%), 1 (22.2%), 2 (22.2%), and 4 (30.8%) patients, respectively, were alive with disease; and 2 (22.2%) patients in the PMMF and 4 (30.8%) in the TIMF group had died of local recurrence or distant metastases at between 9 and 38 months. There was a significant survival difference in the A-EF and SFIF groups compared with the PMMF and TIMF groups (P < 0.05).

Conclusions

The A-EF is suitable for reconstructing defects of clinical stage II disease; the SFIF for clinical stage II or III disease; the PMMF for clinical stage III or IV; and the TIMF for clinical stage rCS III or rCS IV disease.
Literature
1.
Ethunandan M, Macpherson DW, Santhanam V. Karapandzic flap for reconstruction of lip defects. J Oral Maxillofac Surg. 2007;65(12):2512–7.CrossRefPubMed
2.
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.CrossRefPubMed
3.
Alvarez GS, Siqueira EJ, de Oliveira MP. A new technique for reconstruction of lower-lip and labial commissure defects: a proposal for the association of Abbe–Estlander and vermilion myomucosal flap techniques. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(6):724–30.CrossRefPubMed
4.
Rifaat MA. Reconstruction of medium-sized defects of oral commissure by combining double full-thickness cheek rhomboidal flaps and a small lip switch flap. Ann Plast Surg. 2011;67(2):134–8.CrossRefPubMed
5.
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.
6.
Huang WC, Chen HC, Jain V, Kilda M, Lin YD, Cheng MH, Lin SH, Chen YC, Tsai FC, Wei FC. Reconstruction of through-and-through cheek defects involving the oral commissure, using chimeric flaps from the thigh lateral femoral circumflex system. Plast Reconstr Surg. 2002;109(2):433–41.CrossRefPubMed
7.
Valentini V, Saltarel A, Cassoni A, Battisti A, Egidi S. One-stage reconstruction of a defect of the oral commissure and of the cheek with a radial forearm free flap. J Craniofac Surg. 2008;19(6):1508–11.CrossRefPubMed
8.
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.CrossRefPubMed
9.
Fang SL, Zhang DM, Chen WL, Wang YY, Fan S. Reconstruction of full-thickness cheek defects with a folded extended supraclavicular fasciocutaneous island flap following ablation of advanced oral cancer. J Cancer Res Ther. 2016;12(2):888–91.CrossRefPubMed
10.
Chen WL, Wang YY, Zhang DM, Fan S, Lin ZY. Extended vertical lower trapezius island myocutaneous flap versus pectoralis major myocutaneous flap for reconstruction in recurrent oral and oropharyngeal cancer. Head Neck. 2016;38(S1):E159–64.CrossRefPubMed
11.
Yang ZH, Zhang DM, Chen WL, Wang YY, Fan S. Reconstruction of through-and-through oral cavity defects with folded extended vertical lower trapezius island myocutaneous flap. Br J Oral Maxillofac Surg. 2013;51(8):731–5.CrossRefPubMed
12.
Chen W, Yang Z, Zhang D, Wang Y, Fan S, Huang Z. Second salvage surgery with extended vertical lower trapezius island myocutaneous flap reconstruction for advanced re-recurrent oral and oropharyngeal squamous cell carcinoma. Int J Oral Maxillofac Surg. 2014;43(5):531–8.CrossRefPubMed
13.
Edge SB, Byrd DR. Compton CC. AJCC cancer staging manual. 7th ed. New York (NY): Springer–Verlag; 2010.
14.
Chen W, Li J, Yang Z, Yongjie W, Zhiquan W, Wang Y. SMAS fold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- and retroauricular incisions to improve cosmetic outcome and prevent Frey's syndrome. J Plast Reconstr Aesthet Surg. 2008;61(8):893–8.CrossRef
15.
16.
Avery CM, Crank ST, Neal CP, Hayter JP, Elton C. The use of the pectoralis major flap for advanced and recurrent head and neck malignancy in the medically compromised patient. Oral Oncol. 2010;46(11):829–33.CrossRefPubMed
17.
Schneider DS, Wu V, Wax MK. Indications for pedicled pectoralis major flap in a free tissue transfer practice. Head Neck. 2012;34(8):1106–10.CrossRefPubMed
18.
Chen WL, Zhang B, Wang JG, Yang ZH, Huang ZQ, Zhang DM. Reconstruction of large defects of the neck using an extended vertical lower trapezius island myocutaneous flap following salvage surgery for neck recurrence of oral carcinoma. J Plast Reconstr Aesthet Surg. 2011;64(3):319–22.CrossRefPubMed
Metadata
Title
Comparison of the reconstruction of through-and-through cheek defects involving the labial commissure following tumor resection using four types of local and pedicle flaps
Authors
Wei-liang Chen
Yan Wang
Bin Zhou
Juan-kun Liao
Rui Chen
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Head & Face Medicine / Issue 1/2019
Electronic ISSN: 1746-160X
DOI
https://doi.org/10.1186/s13005-019-0196-6

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