lip reconstruction

嘴唇重建
  • 文章类型: Case Reports
    口腔鳞状细胞癌(SCC)的手术治疗导致由癌组织的去除引起的组织缺陷。有各种重建选项可用于唇结构。收获皮瓣以重建这些缺陷无疑会导致大量发病率。嘴唇重建可以更有效地进行,并通过利用皮瓣减少副作用,这可以最大限度地减少供体部位的发病率并缩短手术采集时间。我们正在报告一例,涉及一名52岁的男性,患有嘴唇SCC,没有任何合并症。此病例报告描述了在完全手术切除病变后,使用Fujimori门瓣技术进行仔细的嘴唇重建。
    The surgical treatment of oral squamous cell carcinoma (SCC) results in tissue defects caused by the removal of the cancerous tissue. There are various reconstruction options available for lip construction. Harvesting the flap to reconstruct these defects undoubtedly results in substantial morbidity. Lip reconstruction can be performed more efficiently and with reduced side effects by utilizing flaps, which can minimize donor site morbidity and shorten surgical harvesting time. We are reporting a case involving a 52-year-old male with SCC of the lip who presented without any comorbidity. This case report describes the careful lip reconstruction using the Fujimori gate flap technique following complete surgical excision of the lesion.
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  • 文章类型: Journal Article
    背景:大全厚度唇缺损是重建的挑战。
    目的:描述减压角肌皮(DAOM)皮瓣作为轴型转位皮瓣重建大型,全厚唇缺陷。
    方法:对2011年至2018年接受DAOM皮瓣重建的大型全层唇缺损成人进行多中心回顾性队列研究。对DAOM皮瓣的解剖结构和手术技术进行了综述。皮瓣活力的主要结果以及术后并发症和功能结果的其他临床结果被记录,随访长达11年。分析了平均住院时间和平均机构护理成本。
    结果:共有12例患者接受了DAOM皮瓣重建,以修复大型全层唇缺损。皮瓣存活100%,没有再手术或再入院。所有患者报告维持不同的口腔连合,宽的口腔开口和完整的牙龈沟,优秀的口语能力,和可理解的演讲。平均病例长度为144±11.5分钟,平均住院时间为1.6±0.5天,估计平均机构费用为$3766.67±$1167.06。
    结论:DAOM皮瓣是治疗大型全厚度唇缺损的一种极好的重建选择,具有强大的功能效果和有限的供体部位发病率和机构护理成本。
    BACKGROUND: Large full-thickness lip defects present a reconstructive challenge.
    OBJECTIVE: To describe the impact on clinical outcomes and institutional cost of the depressor anguli oris myocutaneous (DAOM) flap as an axial pattern transposition flap for reconstruction of large, full-thickness lip defects.
    METHODS: A multicenter retrospective cohort study of adults with large full-thickness lip defects who underwent DAOM flap reconstruction from 2011 to 2018 was conducted. DAOM flap anatomy and surgical technique were reviewed. The primary outcome of flap viability as well as additional clinical outcomes of postoperative complications and functional results were documented with follow-up ranging up to 11 years. Median length of stay and average institutional cost of care were analyzed.
    RESULTS: A total of 12 patients underwent DAOM flap reconstruction for large full-thickness lip defects. There was 100% flap survival with no episodes of reoperation or readmission. All patients reported maintenance of distinct oral commissures, wide oral opening and full gingivolabial sulcus, excellent oral competence, and intelligible speech. Mean case length was 144 ± 11.5 min with a mean length of stay of 1.6 ± 0.5 days and estimated mean institutional cost of $3766.67 ± $1167.06.
    CONCLUSIONS: The DAOM flap is an excellent reconstructive option for large full-thickness lip defects with strong functional results and limited donor site morbidity and institutional cost of care.
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  • 文章类型: Journal Article
    目的:阐明在创建个性化唇裂模拟模型时采用的设计和制造方法,主要用于加强外科培训和多样化的应用。该研究进一步试图评估将此模拟模型集成到本科口语实验和教学设置中的可行性。
    方法:使用扫描仪获取唇裂患者的面部数据。随后的阶段涉及逆向工程和利用3D打印技术来生成唇裂硅胶仿真模型。模制过程需要将硅酮注射到聚乳酸模具中。这项研究招募了53名牙科专业的本科生,他们被随机分配到对照组或实验组。一名专门的教练独立指导每个小组,采用多项选择测试和调查的组合来衡量实时评估并辨别群体间的差异。
    结论:我们成功设计并制作了个性化唇裂模拟模型,在唇裂实验教学中表现出显著的疗效。统计分析显示,实验组学生在与唇裂外科手术有关的多项选择题上的得分存在显着差异(P<0.05)。调查结果表明,实验组学生在唇裂手术中表现出更高的信心水平,正如他们对相关问题的回答所反映的那样,与传统的学生群体相比。差异均有统计学意义(P<0.05)。本研究开发的仿真模型是唇裂手术的可靠且具有成本效益的培训和教学工具。
    OBJECTIVE: To elucidate the design and fabrication methodologies employed in creating a personalized cleft lip simulation model, primarily intended for enhancing surgical training and diverse applications. The study further sought to assess the viability of integrating this simulation model into undergraduate oral experiments and instructional settings.
    METHODS: Facial data from individuals with cleft lip conditions were acquired using a scanner. Subsequent stages involved reverse engineering and the utilization of 3D printing technology to generate a cleft lip silicone simulation model. The molding process entailed injecting silicone into a polylactic acid mold. The study enrolled 53 undergraduate students majoring in dentistry, who were randomly assigned to either a control or experimental group. A dedicated instructor guided each group independently, employing a combination of multiple-choice tests and surveys to gauge real-time evaluations and discern inter-group disparities.
    CONCLUSIONS: We successfully designed and produced a personalized cleft lip simulation model, demonstrating notable efficacy in the context of cleft lip experimental teaching. Statistical analysis revealed a significant difference (P < 0.05) in the scores of the experimental group students on multiple-choice questions pertaining to cleft lip surgical procedures. Survey outcomes indicated that the experimental group students exhibited higher confidence levels in cleft lip surgery, as reflected from their responses to relevant questions, compared to the traditional group students. These differences were statistically significant (P < 0.05). The simulation model developed in this study emerges as a reliable and cost-effective training and teaching tool for cleft lip surgery.
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  • 文章类型: Journal Article
    重建下唇的朱红色缺陷需要仔细考虑功能和美学方面。传统上,涉及从嘴角推进组织的各种局部皮瓣方法,外侧下巴,和内侧脸颊通常用于填补下唇缺陷。然而,这些方法有固有的局限性,其中包括技术复杂性,口轮匝肌的破坏,收紧唇,微小口腔,可见的疤痕。为了克服这些限制,我们从下唇使用了游离的肌层复合移植物来重建中小型的朱红色缺损。我们的技术基于简单且可重复的手术方法,可促进组织的自然体积重排。此外,这种方法可以实现精确的嵌入和无张力的修复,防止嘴唇收紧,并提供出色的美学效果,没有垂直疤痕和与周围组织的适当颜色匹配。
    Reconstruction of vermillion defects of the lower lip requires careful consideration of functional and aesthetic aspects. Traditionally, various local flap methods involving tissue advancement from the corner of the mouth, lateral chin, and medial cheek have been commonly employed to fill lower lip defects. However, these approaches have inherent limitations, which include technical complexity, disruption of the orbicularis oris muscle, lip tightening, microstomia, and visible scarring. To overcome these limitations, we employed a free myomucosal composite graft from the lower lip to reconstruct small to medium vermilion defects. Our technique is based on a simple and reproducible surgical approach that facilitates natural volume rearrangement of tissues. Moreover, this method enables precise inset and tension-free repair, prevents lip tightening, and offers excellent aesthetic outcomes with no vertical scarring and appropriate color matching with surrounding tissues.
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  • 文章类型: Journal Article
    鳞状细胞癌(SCC)切除后的嘴唇重建应恢复功能和美学作用;然而,这仍然是一个挑战。在这项研究中,我们描述了嘴唇SCC的临床特征,并提出了一种重建算法。我们回顾性分析了2006年1月至2022年3月在Mohs显微照相手术后接受重建的34例嘴唇SCC患者。患者的平均年龄为70.2岁。7个肿瘤位于上唇,27个肿瘤位于下唇。粘膜唇上有25个缺损,八个缺陷涉及粘膜和皮肤嘴唇,一个缺陷局限于皮肤唇。18个缺陷小于总唇尺寸的50%,16个大于50%。对于小于嘴唇尺寸的50%的缺陷(9/18例),主要进行了初次闭合。和局部皮瓣,根据缺陷的位置和大小,对较大的缺陷执行。13例患者出现术后并发症,但在术后1年内好转,除了一个病人。我们建议一种具有50%截止值的重建算法。可以通过初次闭合来重建小于嘴唇尺寸的50%的缺陷。通过从剩余的邻近组织创建局部皮瓣,可以重建更大的缺损,而术后并发症最少。
    Reconstruction of lips after squamous cell carcinoma (SCC) removal should restore functional and aesthetic roles; however, it remains a challenge. In this study we describe the clinical features of lip SCC and suggest a reconstruction algorithm. We retrospectively analyzed 34 patients with lip SCC who underwent reconstruction after Mohs micrographic surgery between January 2006 and March 2022. The mean age of the patients was 70.2 years. Seven tumors were on the upper lip and 27 tumors were on the lower lip. Twenty-five defects were located on the mucosal lip, eight defects involved both the mucosal and cutaneous lips, and one defect was confined to the cutaneous lip. Eighteen defects were smaller than 50% of the total lip size, and 16 were larger than 50%. Primary closure was mostly performed for defects smaller than 50% of the lip size (9/18 cases), and local flap, according to the location and size of the defects, was performed for larger defects. Thirteen patients experienced postoperative complications but improved within 1 year after surgery, except for one patient. We suggest a reconstruction algorithm with a 50% cut-off value. Defects smaller than 50% of the lip size could be reconstructed by primary closure. Even larger defects could be reconstructed by creation of a local flap from the remaining adjacent tissue with minimal postoperative complications.
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  • 文章类型: Case Reports
    由于嘴唇的结构和功能是多种多样的,因此没有用于嘴唇重建的标准化技术。我们使用双侧斜粘膜V-Y推进瓣开发了一种新的嘴唇重建方法。我们介绍了一个患有严重痴呆症的76岁女性的案例,因为她的下唇上有个肿瘤而向我们的研究所求助。她被诊断为唇鳞状细胞癌(cT2N0M0)。肿瘤测量为25×20mm。它被切除,手术安全裕度为6毫米。双侧三角形皮瓣倾斜地制作在缺损的后外侧,从唇粘膜延伸到颊粘膜,用于修复缺损。手术时间为66min。术后第四天出院,无任何并发症。言语和食物摄入功能已得到保留,她已随访26个月,无复发。尽管嘴唇略微变薄,但嘴唇闭合和颜色匹配已经足够。这种技术提供了一个主要的好处,短的手术和住院时间,因为它是一个简单的,侵入性较小,一步程序。这是一个实用的程序,适合高龄或有合并症的脆弱患者。
    There is no standardized technique for lip reconstruction because the structure and functions of the lip are diverse. We developed a new lip reconstructive approach using a bilateral oblique mucosal V-Y advancement flap. We present the case of a 76-year-old woman with severe dementia, referred to our institute for a tumor on her lower lip. She was diagnosed with lip squamous cell carcinoma (cT2N0M0). The tumor measured 25 × 20 mm. It was resected with a surgical safety margin of 6 mm. Bilateral triangular flaps were fashioned obliquely on the rear lateral side of the defect extending from the labial to the buccal mucosa and used to repair the defect. The operation time was 66 min. She was discharged on the fourth postoperative day without any complications. Speech and food intake functions have been preserved and she has been followed up for 26 months with no recurrence. The lip closing and color match has been adequate despite a slight thinning of the lip. This technique offered a major benefit of short operation and hospitalization time because it was a simple, less-invasive, one-step procedure. This is a practical procedure, suitable for vulnerable patients of advanced age or with comorbidities.
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  • 文章类型: Case Reports
    使用粘膜穿支皮瓣进行下红唇重建是低侵入性的,并且坚持“喜欢与喜欢”的概念。“使用彩色多普勒超声可以很容易地检测到粘膜穿孔器的位置。
    唇缘重建应提供关于功能性和美学的高度结果。我们描述了使用粘膜穿孔器重建下红唇的情况。一名81岁男子主诉下红唇粘膜下静脉畸形反复出血,手术在局部麻醉下进行。静脉畸形完全切除。一个4厘米×2厘米的三角形皮瓣,包含一个粘膜穿孔器,术前使用彩色多普勒超声识别,被设计在邻近缺陷的下红唇。穿支皮瓣在粘膜下层凸起,缺损以前进的方式被皮瓣覆盖。皮瓣转移相关缺损闭合,在为期一年的后续检查中,没有复发,流口水,或观察到言语障碍。在这种情况下,使用粘膜穿支皮瓣进行低侵入性重建后,获得了出色的功能和美学效果。
    UNASSIGNED: Lower red lip reconstruction using a mucosal perforator flap is low-invasive and adheres to the concept of \"like with like.\" The location of the mucosal perforator can easily be detected using color Doppler ultrasound.
    UNASSIGNED: Lip reconstructions should provide results of a high degree regarding both functionality and esthetics. We describe a case of lower red lip reconstruction using a mucosal perforator. An 81-year-old man complained of repeated bleeding from a submucosal venous malformation on his lower red lip, and surgery was performed under local anesthesia. The venous malformation was completely resected. A 4 cm × 2 cm triangle-shaped flap containing a mucosal perforator, identified using color Doppler ultrasound preoperatively, was designed in the lower red lip adjacent to the defect. The perforator flap was raised in the submucosal layer, and the defect was covered with the flap in an advancement manner. The flap transfer-related defect was closed, and at the one-year follow-up examination, no recurrence, drooling, or speech impediment was observed. In this case, excellent functional and esthetic results were achieved following the low-invasive reconstruction using a mucosal perforator flap.
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  • 文章类型: Case Reports
    手术是一种矫正口角或口腔连合处畸形的手术。在这里,我们报告了一例使用裂开干唇进行连缝成形术治疗的术后小口。在外科手术中,干唇分为口轮匝肌皮瓣,并转移到裂隙中形成。改善了嘴角的变形,张口改善到足以佩戴假牙。我们相信这种方法可以实现将美学与功能相结合的连缝成形术。
    Commissuroplasty is a procedure that is performed to correct deformities at the corner of the mouth or oral commissure. Herein, we report a case of postoperative microstomia treated with commissuroplasty using split dry lips. In a surgical procedure, the dry lip was divided into orbicularis oris muscle cutaneous flaps and transpositioned into the cleft formed. The deformation of the corners of the mouth improved, and mouth opening improved enough to wear dentures. We believe that this method enables commissuroplasty that combines aesthetics with function.
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  • 文章类型: Journal Article
    目的:建立部分外伤性上唇畸形的分类方法,验证分类修复方法优于传统非分类修复方法。
    方法:将部分组织缺损小于总唇长1/3的嘴唇畸形分为3种类型,并根据hilum脊和口轮匝肌受累程度进行相应的手术。以及卷线不连续的程度。在这篇综述中,42例病例在分类设计之前是非分类的历史对照,共分类67例。术后12个月收集数据。比较所有患者的术前、术后资料。
    结果:在分类患者中,疤痕宽度明显减小,从3.1±0.6mm降至1.2±0.2mm;沟线高度差从3.3±0.9mm降至0.9±0.1mm;患侧与健康侧的朱红色面积比从1.37±0.31降至1.05±0.17显着下降;III型患侧与健康侧的唇峰高度比从1.91±0.32降至1.07±0.12显着下降;患者满意率约为98.5%。
    结论:临床结果显示,与未分类组相比,分类组的嘴唇美学有显著改善,患者满意度高。
    Establish a classification method for partial traumatic upper lip deformity and verify the classified repair method is superior to the traditional non-classified method.
    Lip deformities caused by partial tissue defects of less than one-third of total lip length were classified into three types and conducted corresponding surgery based on philtrum ridge and orbicularis oris muscle involvement as well as the extent of roll line discontinuity. In this review, 42 cases were non-classified historical controls before the classification was devised, and 67 cases were classified. Data were collected 12 months after surgery. The pre- and post-operative data of all patients were compared.
    In classified patients, the scar width decreased significantly, from 3.1 ± 0.6 mm to 1.2 ± 0.2 mm; the height difference of the groove line was significantly reduced from 3.3 ± 0.9 mm to 0.9 ± 0.1 mm; the ratio of the vermilion area of the affected to healthy side decreased significantly from 1.37 ± 0.31 to 1.05 ± 0.17; the ratio of the lip peak height of the affected to healthy side in type III decreased significantly from 1.91 ± 0.32 to 1.07 ± 0.12; patient satisfaction rate was about 98.5 percent.
    Clinical outcomes showed significant improvement of lip aesthetics with a high patient satisfaction rate in the classified group than the non-classified group.
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  • 文章类型: Journal Article
    背景:嘴唇重建旨在保持面部亚基的功能和美学。重建嘴唇的感觉有助于丸剂的形成,触觉辨别,和热感觉。在这项研究中,我们旨在描述使用各种功能参数进行唇重建的随机模式鼻唇沟皮瓣。
    方法:这是22例癌唇患者的回顾性研究,这些患者接受了手术切除和感觉鼻唇瓣重建。研究了几种临床病理参数。结果参数,如口头能力,触感,评估了重建嘴唇和言语结果的热敏感性。
    结果:在19例患者中获得了2-4mm两点判别的功能结果。所有患者都有清晰的言语。平均沟深度为19.59mm。一名患者由于伤口感染而部分皮瓣丢失。
    结论:随机模式的鼻唇沟皮瓣通过保持触觉和热敏感性提供了良好的功能结果。
    BACKGROUND: Lip reconstruction aims at maintaining the function and aesthetics of the facial subunits. Sensation in the reconstructed lip helps in bolus formation, tactile discrimination, and thermal sensation. In this study, we aim to describe random pattern nasolabial flap for lip reconstruction using various functional parameters.
    METHODS: This is a retrospective study of 22 patients with carcinoma lip who underwent surgical resection and reconstruction with sensate nasolabial flap. Several clinicopathological parameters were studied. Outcome parameters like oral competence, tactile sensation, thermal sensitivity of reconstructed lip and speech outcomes were evaluated.
    RESULTS: A functional outcome with 2-4 mm of two-point discrimination was obtained in 19 patients. All patients had intelligible speech. A mean sulcus depth of 19.59 mm was achieved. One patient had partial flap loss owing to wound infection.
    CONCLUSIONS: Random pattern senate nasolabial flap offers a good functional outcome by maintaining the tactile and thermal sensitivity.
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