title: Application of modified Karapandzic flaps in large lower lip defect reconstruction.
abstract: OBJECTIVE
  Reconstruction of a lower lip defect with a Karapandzic flap often leads to greater rounding of the commissure. The aim of this study was to provide a new design of bilateral Karapandzic flap for large lower lip defect reconstruction.
  
  
  METHODS
  In this case-series retrospective study, a modification of the Karapandzic lip reconstruction technique was used with an additional incision to obtain more tissue. The esthetic outcome of the reconstruction was assessed using a 4-point scale with regard to the shape of the commissure, lip symmetry, appearance of the scar, and lip projection. Functional outcome was assessed by speech, preservation of oral competence, lip sensation, facial expression, diet, and denture usage.
  
  
  RESULTS
  Seventeen patients (13 male, 4 female; age range, 52 to 82 yr) with squamous cell carcinoma in the lower lip underwent single-stage lip reconstruction. Lip defects after tumor resection ranged from 50 to 90% of the lower lips. All patients achieved oral competence, without leading to greater rounding of the commissure. The esthetic outcome was considered good to excellent in 88% of cases and reconstruction did not lead to functional impairments in speech, oral competence, lip sensation, facial expression, diet, or denture usage.
  
  
  CONCLUSIONS
  The modified bilateral Karapandzic flap is a reliable technique to reconstruct large lip defects without leading to rounding of the commissure. With this technique, good esthetic and functional outcomes can be achieved.
authors: Associate Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, and Shanghai Research Institute of Stomatology, Shanghai, China.
authors: Weimin
authors: W
authors: Ye
authors: Attending Surgeon, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, and Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: huyayi@shsmu.edu.cn.
authors: Jingzhou
authors: J
authors: Hu
authors: Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, and Shanghai Research Institute of Stomatology, Shanghai, China.
authors: Hanguang
authors: H
authors: Zhu
authors: Professor, Department Head, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, and Shanghai Research Institute of Stomatology, Shanghai, China.
authors: Chenping
authors: C
authors: Zhang
authors: Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, and Shanghai Research Institute of Stomatology, Shanghai, China.
authors: Zhiyuan
authors: Z
authors: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002921:Cicatrix / Q000473:pathology; D003778:Dentures; D004032:Diet; D004954:Esthetics; D005149:Facial Expression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012677:Sensation / Q000502:physiology; D013060:Speech / Q000502:physiology; D013524:Surgical Flaps / Q000601:surgery*; D016896:Treatment Outcome