NEW APPLICATION FOR THE BITEMPORAL (VISOR) FLAP IN RECONSTRUCTION OF ADVANCED LOWER LIP CARCINOMA

Background: Lip carcinoma is a common cancer with a good prognosis and when patients refer early in the course of disease the results of treatment are acceptable. Surgical procedures for reconstruction of lip defects are the use of remaining lip tissue, tissue from the opposite lip, adjacent cheek tissue, distant flaps and microvascular free flaps. The bitemporal (visor) flap is a regional flap that is used in large advanced upper lip lesions. This study shows that it can be used in the reconstruction of total lower lip lesions. It is in the same operative field, the defect can be covered in the same operation, spread of disease is detected more easily, and it can camouflage the scar. In male patients it is very acceptable aesthetically and multiple surgical teams are not required. Methods: Two patients with advanced lower lip squamous cell carcinoma were operated and the defect reconstructed with a bitemporal (visor) flap. After the hair is shaved, a bipedicle temporal flap including the major branch of the superficial temporal artery was swung in two portions over the defect, and a split -thickness skin graft used to cover the donor site. Results: Both patients had no major problem with deglutition or speech after sectioning the pedicles. Conclusion: The bipedicle temporal flap can be used for reconstruction of midface defects. There is no report of lower lip reconstruction with the bitemporal flap. This study shows that the bitemporal flap can be used in reconstruction of total lower lip lesions, especially in male patients. It is in the same field, the defect can be covered in the same operation, spread of disease is detected more easily, it can camouflage the scar and does not require two team management.