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Title: Case Report: Reconstruction of Labial Commissure, Lip and Buccal Mucosa following Resection of Recurrent Squamous Cell Carcinoma in a Previously Irradiated Field


Authors: Akinsola Ogunbowale, Eva Danaher, Hamid Ramadan, Michael Gilbride
Publication: Journal of The Irish Head and Neck Society - 2025
Issue: 3 Volume: 3
Published: February, 2025 View PDF

Background:
70-year-old female previously treated for Squamous Cell Carcinoma (SCC) of the right mandible and right labial commissure represents with a non-healing ulcer on the right labial mucosa extending to the maxillary alveolus. Reconstruction following resection of the SCC poses a significant challenge due to previous radiotherapy associated with treatment of the SCC on the right labial commissure, a field needed in reconstruction of the resected site. The aim of the patient’s treatment being tumour resection, restoration of function and a level of aesthetic restoration.

Methods:
Careful consideration of reconstructive flap in this case was needed due to the compromised vascularity of the previously irradiated tissue. A modified Karapandzic flap along with a V-Y flap and placement of Integra intraorally was the treatment modality of choice, conserving nerves, enhancing blood supply as well as providing adequate adaptation and functional restoration.

Results:
The selected flaps provided majority stable wound healing, restored oral competence, and preserved speech and oral intake. The patient recovered without major complications.

Conclusion:
Oral commissure reconstruction in previously irradiated patients requires meticulous flap selection to optimise vascularity and function. A tailored approach is essential to achieving functional and aesthetic outcomes while satisfying the primary objective of complete tumour excision.

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