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[Reconstruction of the oral commissure in microstomia patients with deep dermal facial burns: a modified technique].

BACKGROUND
Deep thermal dermal wounds of the oral region with subsequent microstomia are a rare and complex indication for surgical reconstruction of the oral commissure. Apart from functional and mimic aspects, aesthetic expectations are high. Based on converse technique, we performed a reconstruction of the oral commissure in 17 patients. 8 of these needed surgical re-operation due to recurrence and insufficient results. This high rate of complications led to a modification of the surgical procedure.


PATIENTS
We present a modified technique which gave good results in our clinic. Based on Fairbank's technique, we altered the technique by covering the soft tissue defect of the lateral lip with an additional rotation flap raised from the mucosa of the enoral lower lip. Resulting scars were thereby shifted to the enoral side of the lower lip which caused less contracture in the region of the oral commissure.


RESULTS
Using this modified technique, we were able to achieve a lasting displacement of the oral commissure to the lateral side. Long-term follow-up showed good functional results with no need for additional procedures.