| BackgroundLip is one of the most important anatomical and functional organs in oral and maxillofacial region. It will give rise to burden for patients both in physically and mentally when benign and malignant tumors and trauma and other reasons cause lips changing the original anatomical configuration. Therefore, it is a big challenge to reconstruct the lip defect for recovering the morphology and function of lips.Objective1.To investigate the epidemiological characteristics of lip defect and analyze them respectively.2.It will provide the basis for choosing the best therapeutic schedule of lip defect by evaluating the postoperative effect of lip defect reconstruction, insight into the anatomical characteristics of lips and exploring different ways of anesthesia and surgery.3.On the premise of lip defect reconstruction, recover the normal physiological structure and function furthest, and summarize the surgical principles of lip defect reconstruction.Materials and methodsTo collect 136 patients who were diagnosed with lip defect treated at the ward of stomatology of First Affiliated Hospital of Dalian Medical University between January 2001 and December 2014, and retrospective analyze the clinical data of these patients, including gender, age, occupation, pathogenic factors, the position and size of defect, the selection of anesthesia and surgical methods and so on. Then, to evaluate the postoperative effect of lip defect reconstruction and investigate the satisfaction of the patients, and draw the rating scale. Finally, to test the rating scale.Results1.In 136 cases of lip defect patients,86 cases are male and 50 cases are female, the proportion of male and female is 1.72:1. Among these patients, the youngest one is 1 year old and the eldest one is 85 years old. The average age is 52 years old and the median of age is 59 years old.45.59% patients are between 60 and 79 years old, and they get the highest incidence. Retirees (36.76%) and manual workers (32.35%) are the main patients of lip defect. The main reason for lip defect is the malignant tumors (44.85%), others are trauma (27.21%), benign tumors (13.23%), scar (9.56%) and inflammation (5.15%).39 cases are the upper lip defect (28.68%) and 97 cases are the lower lip defect (71.32%). The square of upper or lower lip defect less than 1/2, between 1/2 and 2/3 and more than 2/3 accounts for 67.65%,30.88% and 1.47% respectively. Involving and not involving in the corner of the mouth are 4.41% and 95.59% respectively. In anesthesia methods,57 cases are general anesthesia (41.91%) and 79 cases are local anesthesia (58.09%). The main surgical method is sutured directly (108 cases,78.68%), others are Bernard flap (13 cases,9.55%), Estlander flap (11 cases,8.09%), Karapandzic flap (2 cases,1.47%), vestibular extension (2 cases, 1.47%), and chaulinoplasty (1 case,0.74%).2.Paying a return visit to 136 patients for 1 month,3 months,6 months and 12 months after surgery, we evaluate the postoperative effect and satisfaction by morphology and function of lips. As time goes on, the score is higher and higher (P＜0.05). It suggests that patients are better and better.Conclusion1.Lip carcinoma is the main pathogenic factor of lip defect, and male between 60 and 79 years old gets a higher incidence.2.The best surgical period of lip defect reconstruction is one-stage surgery. Local anesthesia is the best anesthesia method for patients who are not involved in neck dissection.3.Because of the sufficient blood supply, the survival rate of local adjacent flap is high and the rate of necrosis and infection is low. For the patients who get the different positions and sizes of lip defect, individuation reconstruction plans are carried out to meet the requirements of morphology and function of lip.4.The extent and position of lip defect are the main factors to influence the prognostic effect. |
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