Mandibular tongue-shaped flap reconstruction for lip defects following lip tumor surgery

Abstract

Lip defects due to lip tumor surgery need proper reconstruction to preserve their function. Traditional methods offer various options for lip repair, but each has limitations, and can lead to deformity, asymmetry, or functional impairment. This study aimed to investigate the clinical application of mandibular tongue-shaped flap reconstruction for postoperative defects following lip tumor surgery. A retrospective analysis was conducted on the clinical data of 29 patients with lip tumors treated between February 2018 and August 2024. Patients were divided into two groups based on the surgical method: the tongue-shaped flap group (group T, n = 17) and the Abbe flap group (group A, n = 12). Preoperative indicators (preoperative pathology, tumor location), intraoperative and postoperative indicators (operation time, intraoperative blood loss, hospitalization duration, defect repair range), follow-up indicators (scar hyperplasia at 1, 6, and 12 months postoperatively, flap color difference, lip function, patient satisfaction), and complications (postoperative bleeding, flap necrosis, microstomia, incomplete closure, salivation) were compared and analyzed between the two groups. Group T had a significantly shorter operation time, less intraoperative blood loss, and shorter hospitalization duration compared with group A (all p < 0.05). The tongue-shaped flap was suitable for repairing defects ranging from half to the full length of the lip, while the Abbe flap was suitable for defects ranging from one-third to half the length of the lip. Group T demonstrated a wider repair range compared with group A. At 1 month postoperatively, group A showed a statistically significant difference in eating difficulty compared with group T (p < 0.05), while no statistically significant differences were found at 3, 6, and 12 months postoperatively (p > 0.05). There were no statistically significant differences between the two groups in terms of scar hyperplasia, flap color difference, or overall patient satisfaction (p > 0.05). The incidence of microstomia was significantly lower in group T compared with group A (p < 0.05). There were no statistically significant differences between the two groups in the rates of postoperative bleeding, flap necrosis, incomplete lip closure, or salivation (p > 0.05). Mandibular tongue-shaped flap reconstruction is a novel method for repairing postoperative defects following lip tumor surgery. This technique simplifies the surgical procedure while achieving both functional and aesthetic preservation. It offers advantages such as a wider repair range, minimal trauma, shorter operation time, faster postoperative recovery, shorter hospitalization duration, and a lower incidence of microstomia. Patients demonstrate good tolerance, making it particularly suitable for elderly and high-risk patients. This method may become a new option for repairing defects following lip tumor excision.

Keywords: Lip defects; Lip tumor surgery; Mandibular tongue-shaped flap; Reconstruction; Repair.