Clinical Application Of Modified M-shaped Flap And Abbe Flap In Repairing Postoperative Defect Of Lower Lip Cancer

Objective: To observe the effect of modified M-shaped flap and traditional Abbe flap in repairing the defect of lower lip cancer after resection,and provide a reference for clinical application.Methods: Thirty patients with lower lip cancer admitted to the department of Oral and Maxillofacial Surgery,People's Hospital of Xinjiang Uygur Autonomous Region.The patients were followed up for flap survival,mouth opening,denture use,bilateral symmetry,recurrence,survival and so on.Results: Thirty patients with lower lip cancer were reconstructed immediately after surgery,and the defect ranged from 1/3 to 1/2 of the full length of the lower lip after tumor resection.Fourteen patients were repaired with modified M-shaped flaps,and Sixteen patients were treated with traditional Abbe flap repair.All patients had reconstructed the continuity of the orbicularis oris muscle,the flap had a stable blood supply,and the flap survived completely without complications such as bleeding,infection or flap necrosis.Patients in the group recovered good lip movement and sensation,no obvious obstacles to open and closed mouth,pronunciation,and dietary function.The average maximum opening degree(3.06±0.23)cm after repaired with modified M-shaped flaps,and the average maximum opening degree(2.90±0.23)cm after repaired with traditional Abbe flaps,with no significant statistical difference(P > 0.05).The mouth angles of the two groups of patients were preserved,the color of the flap matched the face,the shape of the lower lip was natural and beautiful,and the scar was not obvious,85.7%(12/14)of patients with modified M-shaped flaps had bilateral symmetry,and 62.5%(10/16)of patients with traditional Abbe flaps had bilateral symmetry,with no significant statistical difference(P > 0.05).The overall satisfaction of the modified M-shaped flap was 85.7%(12/14),and the overallsatisfaction of the traditional Abbe flap was 75.0%(12/16),with no significant difference(P>0.05).Patients in the two groups were followed up for 6 months to 4 years(mean 2years and 5 months),and there were no recurrences or deaths.Conclusion: For patients with 1/3 to 1/2 of the lower lip defect,there is no obvious functional and aesthetic difference between the modified M-shaped flap and the traditional Abbe flap.The modified M-shaped flap is more suitable for cases where the defect is located in the center of the lower lip,and the traditional Abbe flap is more suitable for cases where the defect is lateral to the lower lip.