Reconstruction of the oral commissure with the use of a new technique: the asterisk design.
Microstomia reconstruction due to the presence a blunted oral commissure is a challenging task because it requires the restoration of intricately balanced distinct layers of tissues: the oral mucosa, the orbicular muscle, the vermilion border, and the perioral skin. The reliability of commissural reconstruction depends on 2 factors: the first one is breaking the contraction vectors causing blunting of the commissure and the second one is restoring the integrity of the oral sphincter. We have used local skin, vermilion border-muscle, and mucosa flaps designed in an asterisk pattern to break the contraction vectors and have paid certain attention to the restoration of the sphincter function of the circular muscle fibers. Our results have shown that, with the use of our asterisk design, a new commissure aesthetically comparable to the natural one can be created with the reestablishment of reliable oral competence.
Sari
Alper
A
Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Mersin University, Mersin, Turkey. dralpersari@yahoo.com
Aksoy
Alper
A
Basterzi
Yavuz
Y
Unal
Sakir
S
D000293:Adolescent; D000328:Adult; D002648:Child; D003286:Contracture / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008865:Microstomia / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome