Reconstruction of the oral commissure with the Zisser flap

Publication date: Available online 19 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Konstantinos Mantsopoulos, Heinrich Iro, Jannis Constantinidis

Abstract

Purpose

The aim of this study was to investigate the role of the Zisser flap in the reconstruction of defects of the oral commissure. The investigators describe their personal experience with this method and present some interesting aspects from the relevant literature.

Methods

The investigators retrospectively evaluated the records, from the period between 2003 and 2017, of all patients with defects of the oral commissure after resection of malignant tumors, traumas or burns and reconstruction by means of the Zisser flap. They looked for information on the origin of the commissural defect, the method of vermillion reconstruction using the lingual or buccal mucosa, the functional result, the aesthetic outcome and postoperative complications. The functional result of the reconstruction of the oral commissure was assessed regarding postoperative subjective speech integrity, preservation of competence of the oral sphincter and lip sensation. The aesthetic outcome was evaluated regarding limitations in facial expression and scar formation.

Results

The study included 13 patients. Follow–up in the oncological cases was 63.2 months (range: 10-140 months). No tumor recurrences were detected. Vermilion reconstruction was achieved by means of a buccal mucosa flap in eleven cases and a lingual mucosa flap in two cases. All patients but one achieved normal oral competence and mouth opening. In this case, secondary commissuroplasty with restoration of the sphincter function was needed. No cases of blunting or microstomia were detected.

Conclusion

Reconstruction of the oral commissure with the Zisser flap is associated with an outstanding functional outcome that is cosmetically very acceptable.

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