Abstract
Extended composite defects involving the lower lip and chin, mandible, floor of the mouth, and anterior oral cavity mostly result from tumor ablative surgery. But gunshot injuries, advanced stages of infected osteoradionecrosis, and infections are other possible causes. The functional impairment due to loss of tongue and suprahyoid muscle fixation, instability of the remaining mandibular segments, missing teeth, as well as loss of oral competence and motor and sensory nerve function represents a major reconstructive challenge. Moreover, in addition to functional impairments, there is often massive esthetical damage in prominent areas of the lower face, with loss of chin prominence and lip vermilion leading to the Andy Gump deformity. Any reconstructive treatment concept is strongly affected by simultaneous oncologic treatment with adjuvant therapies such as chemotherapy and, in particular, radiation. Depending on the extent of the defect, microsurgical tissue transfer is the most promising option, potentially in combination with local flaps for lip reconstruction. Various treatment algorithms have been published. In general, oral competence is regarded as a major concern. Lip suspension but also bony buttressing for lip support are suggested to restore oral sphincter function. Compared to the enormous reconstructive issues, there are relatively few relevant publications with low case numbers. Our own experience in a cohort of 27 patients is discussed in the context of the literature. It is to conclude that, even nowadays, there is no optimal solution to solve the multitude of functional and esthetic problems.
| Dokumententyp: | Zeitschriftenartikel |
|---|---|
| Fakultät: | Medizin |
| Themengebiete: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
| ISSN: | 1865-9659 |
| Sprache: | Deutsch |
| Dokumenten ID: | 64857 |
| Datum der Veröffentlichung auf Open Access LMU: | 19. Jul. 2019, 12:16 |
| Letzte Änderungen: | 04. Nov. 2020, 13:44 |
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