Extended Karapandzic Flap Technique for Reconstruction of Lower Lip and Chin Defect

Purpose: Near total defect of the lower lip adjacent to the chin remains a reconstructive challenge for surgeons in function and esthetics. The objective of this study was to present a modified extended Karapandzic technique for reconstruction of near total defects of the lower lip adjacent with the chin. Materials and Methods: From 2000 to 2013, patients with lip cancer or oral cavity cancer who required subtotal lower lip and chin resection and subsequently underwent reconstruction with an extended Karapandzic flap were included in this retrospective study. Patient demographics, histopathology, tumor stage, localization, tumor extension, method of reconstruction, and postoperative complications were extracted from patients' documentation. Results: Reconstruction of the lower lip and chin was performed in 21 patients using a combination of double local extended Karapandzic flaps with microvascular free flaps for intraoral and mandibular reconstruction. There was no flap necrosis; the main complications were fistula and exposure of the osteosynthesis plate. All lips were functional and the esthetic result was pleasing. All patients returned to a peroral diet, although a variable degree of microstomia was present. Conclusion: The extended Karapandzic flap technique provides superior results for esthetic and functional lip reconstruction and chin reconstruction compared with any other regional or free flap. Free flaps should be reserved for oral cavity and mandibular reconstruction, if needed. (C) 2017 American Association of Oral and Maxillofacial Surgeons