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Abstract

ABSTRACT: BACKGROUND: The reconstruction of the oral commissure microstomia is one of the complex tasks in plastic surgery and the most important issue to be considered is to provide a good functional and acceptable aesthetic result. Various local and regional flaps have been described for this purpose. The vermilion - mucosa flaps are frequently used flaps in reconstruction of small to medium sized microstomia. The reliable blood supply, minimal donor site morbidity and excellent texture and color match are some of the advantages of these flaps. OBJECTIVE: This study is to evaluate our results with vermilion-mucosa flaps in the reconstruction of oral commissure. PATIENT AND METHOD: This prospective study was done in Sulaimani plastic, reconstructive and burn hospital from April 2008 to September 2009 with minimum follow-ups of 6 months. The total number of patients was fifteen, the age of patient arranged between 1month to 47 years, the flaps designed as vermillion advancement flaps in 7 cases, vermilion-mucosa flaps in 4 cases, and tri -lobes buccal mucosal flaps in 4 cases. The cause of the deformities was , post burn scaring and contracture involving oral commissure, of which twelve cases treated bilaterally, and only three cases treated by unilateral commissuroplasty. RESULTS: The flaps were survived and most of the patients were satisfied with the outcome of the operation. Marginal necrosis of one flap was encountered; drooling was encountered in only one patient and it gradually disappeared with time. CONCLUSION: The oral vermilion mucosa flaps are reliable tools for reconstruction of small to moderate- sized commissure microstomia. The flaps provide good functional and aesthetic results with reduced necessity for prolonged splinting and secondary procedure and minimal donor site morbidity

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