الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Functional and cosmetic restoration of lower lip defects can present a considerable challenge to the reconstructive surgeon. The upper and lower lips represent a distinct anatomic unit that is a major feature of the lower one third of the face, and they have great functional and aesthetic importance. The main function of the lips is to act as the portal to the gastrointestinal system, and in this capacity as a sphincter the lips retain saliva and food in the oral cavity during mastication. As one of the main features of the face, the role of the lips in articulation and conveyance of facial expression and emotion are facilitated by their central attachment to the rest of the facial musculature. The cosmetic result of any procedure to repair lip defects has to take into consideration the fact that the least of abnormalities is very noticeable at conversational distance. Main causes of acquired lip defects include malignancies, in the form of squamous cell carcinoma, precancerous lesions in the form of leukoplakia, vascular malformations, post burn deformities Acquired lip defects can be classified according to the site and size of the defect into; vermilion only defects, defects less than one third of total lip length, defects more than one third and up to two thirds, defects more than two thirds of the horizontal length of the lip which include subtotal or total loss of a lower lip, and defects of the Cutaneous lip only. The aim of this work was to study the reconstruction of acquired lip defects using different surgical techniques in order to achieve a proper plan to facilitate the management of such defects This study was carried out for 30 patients, twenty three (76.7%) patients were males and only seven patients (23.3.5%) were females. Patients were subdivided into five unequal groups, according to the site and size of the acquired lip defect they have. I. First group (G I): This group included 3 patients with vermilion only defects. II. Second group (G II): This group included 2 patients with defects confined to the Cutaneous lip only. III. Third group (G III): This group included 8 patients with full-thickness defects less than one third total lip length. IV. Fourth group (G IV): This group included 14 patients with full-thickness defects between one third and two thirds lip length. V. Fifth group (G V): This group included 3 patients with total or subtotal lip loss All patients were assessed pre-operatively by history taking, assessment of symptoms of oral illness, systemic general examination, and local examination of the lip condition. • Digital photography of the patients, pre, intra, and post-operatively. • Type of procedure: Group I: For three patients with vermilion only defects of the lower lip, 2 mucosal advancement flaps, (133) and 1 tongue flap (153) were done. Group II: For 2 patients with Cutaneous only defects SSG was done. Group III: For 8 patients with full-thickness defects less than one third of total lip length, primary repair (14) was chosen. Group IV: For 14 patients with full-thickness defects between one third and two thirds lip length: were managed with 2 Gillies fan flap (78), 3 inferiorly based nasolabial flaps(114-116), 3 Abbe (46) flaps, 2 Mcgregor (57) flaps, 2 Estlander flaps and 2 Karapandzic flaps. Group V: For 3 patients with total or subtotal lip loss. a) subtotal loss of the lower lip: 1 patients were managed with large bilateral inferiorly based nasolabial flaps.(114) b) Total loss of the lower lip: 2 patients were managed with bilateral extended Karapandzic (77) flaps. Post operative evaluation of cases was done: All cases in this study were followed up for a period of three months. All cases were examined to detect and treat early and late post-operative complications if present. All cases were subjected at the end of the follow up period for aesthetic, functional, and subjective evaluation - Age: Most of the patients (13) (43.3%) were among the age group (40-59) - Sex: Most of the patients were male (23) (76.7%) - Etiology: Squamous cell carcinoma was the most common cause. In (20 patients) (66.7%) - Extent of the defect: Most of the defects were medium sized (1/3-2/3) in (14patients) (46.7%) The performed procedure: The most common flap used in this study was the inferiorly based nasolabial flap 4 patient and Karapandzic flap 4 patients. - Post-operative complications: Infection was the most common post operative complication seen in 4 cases. - Best aesthetic results were achieved in cases managed with primary repair and Mcgregor flap, whereas the least results were with the Karapandzic flap. - Best functional results were achieved in primary repair and Karapandzic flap.