The Establishment of a Treatment Protocol for the Reconstruction of Mid-Sized Defects in Lip Cancer Using Combinations with the Abbe Flap.

Background: When defects occur in the lips due to conditions such as lip cancer, it is essential to reconstruct them both functionally and aesthetically, given the vital roles that lips play in communication, nutrition, and overall appearance. Various flap techniques are available for lip reconstruction, and the surgical method should be chosen based on the location and extent of the defect.

Methods: This article discusses two cases of successful lip reconstruction using a combination of the Abbe flap and additional flaps, tailored to the extent of the defects. In case 1, a 52-year-old female diagnosed with angiosarcoma underwent a wide resection of 1/3 to 2/3 of her upper lip. Reconstruction was performed using an Abbe flap combined with a perialar crescentic flap. In case 2, a 54-year-old male with squamous cell carcinoma had more than 2/3 of his lower lip excised. Although the Bernard-Burrow-Webster flap is typically used for such cases, the patient was reconstructed with an Abbe flap combined with a staircase flap, addressing the limitations of traditional methods.

Results: Both reconstruction surgeries achieved excellent aesthetic and functional outcomes. In case 1, the combination of the Abbe flap and perialar crescentic flap provided the patient with a natural appearance and preserved lip functionality. In case 2, the Abbe flap and staircase flap technique effectively restored lip function while avoiding complications such as microstomia and surgical scars associated with more conventional methods.

Conclusions: The findings underscore that using the Abbe flap in combination with the perialar crescentic advancement flap or staircase flap can effectively restore both the functional and aesthetic integrity of the lips, particularly in cases involving significant tissue loss.