Management of an oro-facial soft tissue defect: a case report

Abstract

Introduction: Repair of large orofacial defects poses a challenge to reconstructive surgeons worldwide because of unpredictable outcome regardless of the skill and technique of choice. The aim of this paper is to
document our experience in the past two years and to report the consecutive use of Bakamjiam (Deltopectoral flap) for cover of cheek/upper lip defect and later for cover and lining of the lower lip.
Method: This is a report of a patient with a soft tissue defect due to excision of a large growth of the face. The defect involving the right cheek and almost two-third of both upper and lower lips was reconstructed with
platysma musculo-cutaneous flap for lining of the cheek and upper lip; and delto-pectoral flap for coverage of the cheek and upper lip as well as for cover, support and lining of the lower lip.

Results: The flaps healed satisfactory. There was a deviation of the right commissure of the lip due to lack of innervation. The new tissue on the cheek was also not as supple as normal facial tissue due to less vasculature and fibrosis.

Conclusion: Free flaps offer the best treatment option for the reconstruction of defects of the orofacial region, but when these tissues can not be harvested due to factors that have been elucidated in this paper, pedicle flaps offer reasonable alternatives.

Keywords: Soft tissue trauma, orofacial defects, Schwannoma, deltopectoral flap