title: The use of a modified abbé island flap to reconstruct primary lip defects of over 80.
abstract: BACKGROUND
  Lip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results. Abbé flaps offer an excellent reconstructive option but are limited to defects under 65 %.
  
  
  METHODS
  We describe a two-stage "modified Abbé island flap" technique whereby a full-thickness myocutaneous flap is combined with a modified Karapandzic flap, allowing for reconstruction of total and near total lip defects.
  
  
  RESULTS
  Six patients underwent successful two-stage lower and upper lip reconstruction with this technique. Oral competence and satisfactory aesthetic outcomes were achieved in all six cases. There were no complications. Although microstomia was noted to a certain extent, we argue this impact to be less than the morbidity of a free flap that lacks sphincteric function.
  
  
  CONCLUSIONS
  The "Modified Abbé Island Flap" can be used to reconstruct near-total lip defects using locally innervated, well-vascularized tissues that recreate the oral sphincter and restore oral competence. The combination of the conventional Abbé flap with a modified Karapandzic flap provides reliable results and significantly reduces operating time.
authors.affiliation: McGill University, Faculty of Medicine, McIntyre Medical Building, 3655 Sir William Osler, Montreal, Quebec, H3G 1Y6, Canada.
authors.forename: Sabin
authors.initials: S
authors.lastname: Filimon
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Royal Victoria Hospital, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3 J1, Canada.
authors.forename: Keith
authors.initials: K
authors.lastname: Richardson
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Jewish General Hospital, 3755 Cote-Sainte-Catherine street, Montreal, Quebec, H3T 1E2, Canada.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hier
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Royal Victoria Hospital, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3 J1, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Roskies
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Jewish General Hospital, 3755 Cote-Sainte-Catherine street, Montreal, Quebec, H3T 1E2, Canada. alexmlynarek@hotmail.com.
authors.forename: Alex M
authors.initials: AM
authors.lastname: Mlynarek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery*; D004954:Esthetics; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007636:Keratoacanthoma / Q000601:surgery; D008046:Lip / Q000601:surgery*; D008047:Lip Diseases / Q000601:surgery; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps
keywords: Abbé flap; Lip reconstruction; Modified Karapandzic; Over 80 % lip defects