Lip Reconstruction Using Radial Forearm Freeflap After Radical Excision of Squamous Cell Carcinoma: A Case Report

Eko Setiawan*  -  General Surgery Resident, Faculty of Medicine University of Diponegoro/ dr. Kariadi General Hospital, Semarang, Indonesia
Erythrina Permata Sari  -  Staff of Department of Plastic and Reconstructive Surgery, Faculty of Medicine University of Diponegoro, dr. Kariadi General Hospital, Semarang, Indonesia

(*) Corresponding Author

INTRODUCTION: The main treatment modality for squamous cell carcinoma of the head and neck is by surgical wide excision. Post-excision reconstructive surgery is essential for restoring aesthetics and function. Fasciocutaneous free-flap is an acceptable method for reconstructing a wide lession of the face since the technique does not cause significant morbidity.

CASE REPORT: A 41 year-old female was diagnosed with squamous cell carcinoma (T3N0M0) of the inferior lip after achieving tumor-free margin radical excision. Reconstruction of the defect was made with radial forearm freelap followed by a three-phase refinement flap. The patient was left with a aesthetically acceptable lip without other facial morbidity.

DISCUSSION: Reconstructive surgery following a widely excised tumor of the lips requires special attention because of its important physical and aesthetical role. Radial forearm freeflap causes minimal facial morbidity since the technique does not require donor tissue from the face. Other benefits include adequate tissue thickness, minimal contracture and unaltering skin color. Further refinement flaps is needed to complete the reconstruction process.

CONCLUSION: Radial forearm free flap is a good choice for reconstruction a wide lession following a wide excision of lip tumor.

Keywords: squamous cell carcinoma;radial forearm free flap

  1. Alamani, J.A., Castaneda, S.S., Fernando, A.F., 2014. Reconstruction of a Large Through and Through Defect of the Oral Cavity Using a Double Anterolateral Thigh Free Flap. Philipp. J. Otolaryngol. Neck Surg. 29, 26–29.
  2. Burusapat, C., Pitiseree, A., 2012. Advanced squamous cell carcinoma involving both upper and lower lips and oral commissure with simultaneous reconstruction by local flap : a case report. J. Med. Case Rep. 6, 23. https://doi.org/10.1186/1752- 1947-6-23
  3. Daya, M., 2010. Simultaneous total upper and lower lip reconstruction with a free radial forearm e palmaris longus tendon and brachioradialis chimeric flap. Br. J. Plast. Surg. 63, e75–e76. https://doi.org/10.1016/j.bjps.2009.01.034
  4. Daya, M., Nair, V., 2009. Free radial forearm flap lip reconstruction: A clinical series and case reports of technical refinements. Ann. Plast. Surg. 62, 361–367. https://doi.org/10.1097/ SAP.0b013e31818b4515
  5. Dediol, E., Luk, I., Virag, M., 2008. Treatment of Squamous Cell Carcinoma of the Lip. Coll Antropol. 32, 199–202.
  6. Géraud, C., Koenen, W., Neumayr, L., Doobe, G., Schmieder, A., Weiss, C., Goerdt, S., Faulhaber, J., 2012. Lip cancer : retrospective analysis of 181 cases. J Dtsch Dermatol Ges. 10, 121–127. https://doi.org/10.1111/j.1610- 0387.2011.07853.x
  7. Harris, L., Higgins, K., Enepekides, D., 2012. Local flap reconstruction of acquired lip defects. Curr Opin Otolaryngol Head Neck Surg. 20, 254–261. https://doi.org/10.1097/MOO.0b013e3283557dcf
  8. Hasson, O., 2008. Squamous Cell Carcinoma of the Lower Lip. J Oral Maxillofac Surg. 6, 1259–1262. https://doi.org/10.1016/j.joms.2008.01.055
  9. Ozturk, K., Gode, S., Erdogan, U., Akyildiz, S., Apaydin, F., 2015. Squamous cell carcinoma of the lip: survival analysis with long-term follow-up. Eur. Arch. Oto-Rhino-Laryngology 272, 3545–3550. https://doi.org/10.1007/s00405-014-3415-6
  10. Rena, W., Lia, Y., Liua, C., Qianga, C., Zhang, L., Gaoa, L., Wangb, Z., 2014. Surgical management of Squamous Cell Carcinoma of the lower lip : An experience of 109 cases. J. Sect. Oral Surg. 19, 398–402. https://doi.org/10.4317/medoral.19595
  11. Shield, K.D., Ferlay, J., Jemal, A., Sankaranarayanan, R., Chaturvedi, A.K., Bray, F., Soerjomataram, I., 2017. The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012. CA. Cancer J. Clin. 67, 51–64. https://doi. org/10.3322/caac.21384
  12. Thorne C. H., 2014. Reconstruction of acquired lip deformities. Grabb and Smith’s Plastic Surgery, 7th ed. Lippincott Williams & Wilkins.

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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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