title: Reconstruction of large defects of the lips and commissure using a composite radial forearm palmaris longus free flap associated with a lengthening temporalis myoplasty.
abstract: We performed a single-stage operation to reconstruct a large defect of the lips and commissure using a composite radial forearm-palmaris longus free flap. To obtain cranial traction and a voluntary smile, independently from any jaw movement, traction was achieved by using a lengthening temporalis myoplasty. The tendon attached to the coronoid process was fixed to the palmaris longus tendon, recreating a new commissure and a "neo-modiolus." Physical therapy was started on the 21st postoperative day to facilitate progress from a "mandibular smile," to ideally a spontaneous and symmetric smile after 3 months of therapy. This procedure was able to obtain good oral continence and a good commissural movement during smile which has not previously been mentioned in the published literature.
authors.affiliation: Department of Maxillo-Facial and Facial Plastic Surgery, University Hospital Center of Tours, Tours, France. doc_cmf@yahoo.fr
authors.forename: Thomas
authors.initials: T
authors.lastname: Martin
authors.forename: Florent
authors.initials: F
authors.lastname: Sury
authors.forename: Dominique
authors.initials: D
authors.lastname: Goga
authors.forename: Jerome
authors.initials: J
authors.lastname: Parmentier
authors.forename: Adam
authors.initials: A
authors.lastname: Rozen
authors.forename: Boris
authors.initials: B
authors.lastname: Laure
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005542:Forearm; D058752:Free Tissue Flaps; D006801:Humans; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons / Q000601:surgery*