Complete loss of lower lip in a one-year-old treated with delayed free tissue transfer: a case report and comprehensive review of the literature.
| Title: | Complete loss of lower lip in a one-year-old treated with delayed free tissue transfer: a case report and comprehensive review of the literature. |
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| Authors: | Beiriger J; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States.; Bestourous DE; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States.; Patel N; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States.; Padia R; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States.; Cannon R; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States.; McCrary HC; Department of Otolaryngology-Head and Neck Surgery, University of Utah, 50 N. Medical Dr., SOM 3C120, Salt Lake City, UT 84132, United States. |
| Source: | Journal of surgical case reports [J Surg Case Rep] 2025 Oct 14; Vol. 2025 (10), pp. rjaf811. Date of Electronic Publication: 2025 Oct 14 (Print Publication: 2025). |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101560169 Publication Model: eCollection Cited Medium: Print ISSN: 2042-8812 (Print) Linking ISSN: 20428812 NLM ISO Abbreviation: J Surg Case Rep Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2013- : Oxford : Oxford University Press; Original Publication: 2010-2012: Halesowen, UK : JSCR Publishing Limited |
| Abstract: | Pediatric lower lip reconstruction is rare and technically challenging due to small donor sites, ongoing facial growth, and functional demands, such as speech and oral competence. We present the case of a one-year-old male who sustained complete avulsion of the lower lip from a dog bite. Initial management included a Karapandzic advancement flap for coverage. Definitive reconstruction at 23 months involved a radial forearm free flap with palmaris longus tendon for static suspension, augmented by acellular dermal matrix. Postoperative dehiscence required revision vestibuloplasty with a split-thickness skin graft. The patient achieved adequate lip suspension, improved sialorrhea, and restoration of oral competence by the first postoperative visit. Free flap reconstruction of the lower lip in children under two is feasible and can yield functional and aesthetic outcomes when individualized planning and multidisciplinary care are employed.; (© The Author(s) 2025. Published by Oxford University Press and JSCR Publishing Ltd.) |
| Competing Interests: | None declared. |
| References: | Ann Surg Oncol. 2017 Dec;24(13):4009-4016. (PMID: 28884452); Plast Reconstr Surg. 2009 Dec;124(6 Suppl):e313-e326. (PMID: 19952700); Laryngoscope. 2019 Aug;129(8):1915-1921. (PMID: 30152141); Curr Opin Otolaryngol Head Neck Surg. 2018 Apr;26(2):127-133. (PMID: 29369088); J Plast Reconstr Aesthet Surg. 2010 Apr;63(4):616-22. (PMID: 19278911); Curr Opin Otolaryngol Head Neck Surg. 2018 Oct;26(5):334-339. (PMID: 30074517); Head Neck. 2008 May;30(5):684-9. (PMID: 17979111); Plast Reconstr Surg. 2004 Jan;113(1):19-23. (PMID: 14707618); J Oral Maxillofac Surg. 2012 Dec;70(12):2899-906. (PMID: 22651938); Ann Plast Surg. 2019 Jan;82(1):62-63. (PMID: 30285989) |
| Contributed Indexing: | Keywords: dog bite trauma; lower lip avulsion; oral competence; pediatric free flap reconstruction; radial forearm free flap; static suspension |
| Entry Date(s): | Date Created: 20251017 Date Completed: 20251017 Latest Revision: 20251019 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12526990 |
| DOI: | 10.1093/jscr/rjaf811 |
| PMID: | 41103495 |
| Database: | MEDLINE |
Case Reports; Journal Article