The use of a modified abbé island flap to reconstruct primary lip defects of over 80 %. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Filimon, Sabin; Richardson, Keith; Hier, Michael; Roskies, Michael; Mlynarek, Alex
• Is Part Of: Journal of otolaryngology - head & neck surgery. Volume 45:Issue 1(2016)
• Page Start: 1
• Page End: 8
• Publication Date: 2016-12
• Subjects: Lip reconstruction -- Abbé flap -- Modified Karapandzic -- Over 80 % lip defects; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; Otorhinolaryngologic Surgical Procedures -- Periodicals; Head -- Surgery; Neck -- Surgery; Otolaryngology; Periodicals; 617.51005
• DOI: 10.1186/s40463-016-0148-0
• Languages: English
• ISSNs: 1916-0208

Abstract

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.