A new sliding rotation flap for functional lip reconstruction after cancer ablation: A technical note

Objective

To establish a new technique for ensuring preservation of orbicularis oris muscle continuity and facial nerve for the lip reconstruction after moderate lower lip cancer ablation.

Methods

The surgical procedure consists of three steps. First, a Z-shaped skin flap is created around the nasolabial groove. The incision is made on the skin and muscular side, but not down to the oral mucosa. The angle of the mouth, orbicularis oris muscle, and facial nerve are not affected by this approach. Next, a careful obtuse dissection is performed to preserve the facial artery, facial nerve and mental nerve and to allow freedom of the flap. Finally, changing of the flap allows sliding rotation of the perioral tissue to reconstruct the lip defect.

Results

The replaced flap pulled new mouth angle outward, and a good morphology was formed. Opening the mouth was sufficiently to wear the dentures. The sphincter movement of the lips was good, and the patient's pronunciation and eating were good.

Conclusion

This method may be a useful option for the reconstruction of lower lip after cancer ablation because the resection with safety margins creates a large lip defect.