The use of a modified abbé island flap to reconstruct primary lip defects of over 80

J Otolaryngol Head Neck Surg. 2016 May 31;45(1):35. doi: 10.1186/s40463-016-0148-0.

Abstract

Background: Lip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results. Abbé flaps offer an excellent reconstructive option but are limited to defects under 65 %.

Methods: We describe a two-stage "modified Abbé island flap" technique whereby a full-thickness myocutaneous flap is combined with a modified Karapandzic flap, allowing for reconstruction of total and near total lip defects.

Results: Six patients underwent successful two-stage lower and upper lip reconstruction with this technique. Oral competence and satisfactory aesthetic outcomes were achieved in all six cases. There were no complications. Although microstomia was noted to a certain extent, we argue this impact to be less than the morbidity of a free flap that lacks sphincteric function.

Conclusion: The "Modified Abbé Island Flap" can be used to reconstruct near-total lip defects using locally innervated, well-vascularized tissues that recreate the oral sphincter and restore oral competence. The combination of the conventional Abbé flap with a modified Karapandzic flap provides reliable results and significantly reduces operating time.

Keywords: Abbé flap; Lip reconstruction; Modified Karapandzic; Over 80 % lip defects.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma / surgery*
  • Esthetics
  • Female
  • Free Tissue Flaps*
  • Humans
  • Keratoacanthoma / surgery
  • Lip / surgery*
  • Lip Diseases / surgery
  • Lip Neoplasms / surgery*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps