Functional Lower Lip Reconstruction with Vascularized Fascia Lata Sling and Masseter Muscle Transfer Following Oral Cancer Ablation-One Case Report

口腔癌術後使用筋膜懸吊及嚼肌轉位行功能性下唇重建－病例報告

楊學穎(Hsueh-Ying Yang) ； 李曜洲(Yao-Chou Lee) ； 李經維(Jing-Wei Lee)

《臺灣整形外科醫學會雜誌》 20卷1期 (2011/03) Pp. 67-72

https://doi.org/10.7096/TJTSPS.201103.0067

摘要

背景：
人體的嘴唇在美觀上及功能上是獨一無二且複雜的構造。其中下唇更扮演著重要的角色，其高度及收縮能力影響著嘴部表情及密合程度。要重建癌症切除術後所造成的大面積下唇缺陷使其具功能性的恢復是極具挑戰性的。針對這一類的臨床問題，過去有不少文獻提出各式的重建方法。然而隨著缺陷的大小及形狀不同，我們很難去尋找到一個一體適用的解決方案。
目的及目標：
我們嘗試去找出一個下唇功能性重建的可能方法。
材料及方法：
我們提出一例病例利用游離前側腿皮瓣帶筋膜懸吊以及嚼肌轉位來同時進行靜態及動態懸吊以達到功能性下唇重建。
結果：
該病患術後能順利以口進食，無流涎情況發生，惟仍須長期追蹤。
結論：
使用游離前側腿皮瓣帶筋膜懸吊以及嚼肌轉位來進行功能性下唇重建，其結果令人滿意，可作爲諸多重建方式之另一選擇。

並列摘要

Background:
The lip is a unique and complex structure that has important implication both functionally and esthetically. The lower lip plays a significant role in oral competence maintenance, and the pre-requisites for a proper reconstruction include an adequate lip height and an effective dynamic sphincter function. There are scattered reports advocating a variety of treatment methods. Yet the defect may present with countless number of types and shapes among different individuals, and a fit-for-all solution doses not really exist.
Aim and Objectives:
In this report, we try to verify the treatment effects of a novel operative method for large lower lip defect repair.
Materials and Methods:
We present a case for whom we used a free anterolateral thigh flap reconstruction plus fascia lata sling and masseter muscle transfer to restore both static and dynamic suspension mechanism of the lower lip.
Results:
The postoperative course of the case was smooth. The patient had good oral competence and was able to resume regular diet without drooling problem, and the contour is quite acceptable after touch-up defatting procedure.
Conclusion:
The use of vascularized fascia lata and masseter muscle transfer can reestablish both static and dynamic suspension function in one-stage reconstruction. Such a novel approach can thus be deemed a viable alternative for lower lip repair.

並列關鍵字

lower lip reconstruction ； vascularized fascia lata sling ； masseter muscle transfer