Reconstruction of lip defects with the Karapandzic technique

Abstract

Objective: To study the use and effects of Karapandzic technique of lip reconstruction by long-term assessment.

Design: A descriptive study.

Place and duration of study: CMH Rawalpindi from January 1994 to January 2002.

Subjects and methods: Thirty seven consecutive patients who underwent Karapandzic technique of lip reconstruction with a minimum follow-up period of two years have been included. The variables assessed were hemorrhage, wound infection, flap necrosis, microstomia, reconstruction time, hospital stay and dynamic lip functions. Results drawn were analyzed.

Results: A total of 37 patients were included in the study. Thirteen (35%) patients were outdoor cases while 24 (65%) were in-patients. Average time of reconstruction was 40 minutes, which was done under general anesthesia in 21(57%) patients and under local anesthesia in 16 (43%) cases. Mean hospital stay of the indoor cases was 26 hours. There was no flap loss except for marginal necrosis in 04 (11%) patients. Wound infection and wound dehiscence was observed in 03 (08%) patients. Sensations were completely intact in 29 (78%) patients and aesthetically 28 (76%) patients gave normal look at the end of two years (2Y). Twenty-seven (74%) patients had no change in speech and only one (3%) patient had unsatisfactory speech after 2 years. Varying degree of microstomia was observed in all the cases at immediate postoperative stage of one month but 35 (95%) patients showed gradual improvement with active mouth opening and stretching by prosthetic splints over 2 years.

Conclusion: The Karapandzic technique of lip reconstruction is strongly recommended over the other techniques as it is a single stage, quick and safe procedure which gives cosmetically and functionally excellent results. Microstomia, occurring in early postoperative stage, shows gradual improvement on long-term follow-up.