Laboratory Studies
The laboratory tests that are required for lip reconstruction are those that would be necessary in any type of surgical intervention. Evaluation of coagulation profile, blood counts, blood chemistry, electrocardiography, chest radiography, and other specialized cardiac and pulmonary tests are indicated as appropriate for the age and medical conditions of each patient.
Imaging Studies
See the list below:
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Most cases of primary lip reconstruction do not require special imaging. If any possibility exists that the underlying mandible is involved with a lower lip neoplasm, CT scanning with bony windows is indicated.
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Consider MRI in those patients who present with preoperative hypoesthesia of the upper or lower lip. In this case, suspicion of infraorbital or submental nerve infiltration may be warranted. Extent of infiltration can certainly have an impact on the choice of extirpative technique.
Diagnostic Procedures
Diagnostic confirmation of cancer is often prudent prior to any extensive resection. Various biopsy techniques are available.
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Large defect of the lateral upper lip side unit is addressed with a perialar crescentic cheek advancement flap. The muscular continuity is preserved, allowing for complete functional restoration.
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The Abbe lip switch flap. Typically, the flap is half the width of the defect to allow for symmetric shortening of the upper and lower lip. A second stage is necessary to ligate the pedicle and finalize flap inset.
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The Estlander lateral lip switch flap. Note that although complete inset is accomplished at the initial stage, a second stage is often warranted to allow for better definition of the oral commissure. As described by Converse, the modiolus is expanded followed by mucosal advancement flaps.
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Near-total upper lip defects are best addressed by treating each subunit individually. The lateral subunits are formed by use of inferiorly based melolabial rotation flaps. The central subunit is created with lip switch. Mucosal advancement flaps are necessary to recreate the vermillion.
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Near-total upper lip defects are best addressed by treating each subunit individually. The lateral subunits are formed by use of inferiorly based melolabial rotation flaps. The central subunit is created with lip switch. Mucosal advancement flaps are necessary to re-create the vermillion.
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The Karapandzic flap is a suitable option for large lower lip defects. The neurovascular pedicles are preserved allowing for adequate sensation and motor function. Since no additional tissue is advanced, a limitation is microstomia.