Assistant Professor of Small Animal Surgical Oncology University of Missouri Columbia, Missouri
Reconstruction of maxillary and maxillary lip defects can be challenging and functional and esthetic outcomes must be considered. Our objective is to describe the technique and outcomes for closure of maxillary lip defects using a buccal transposition flap and identify potential routes of vascular supply to the flap. This is a case series of five client owned dogs and a cadaveric study involving one dog head. Buccal transposition flaps were used for closure and reconstruction of maxillary lip defects in five dogs after wide excision for management of maxillary lip neoplasms. Concurrent maxillectomy was performed in four dogs. A maxillary labial defect and buccal transposition flap were created on a cadaveric dog head. Iodinated contrast was injected into the common carotid artery and computed tomography was performed to assess the vascular supply. All flaps survived in dogs treated clinically. Two dogs developed postoperative complications, including oronasal fistula (n = 2), flap edema (n = 1), and partial flap dehiscence (n = 1). Surgical intervention was required for one of the oronasal fistulae and the partial flap dehiscence. Cosmetic and functional outcome was considered satisfactory in all cases. The cadaver study identified that the buccal transposition flap was perfused by branches of the angularis oris and superior labial arteries. Buccal transposition flaps provided adequate functional and cosmetic outcomes for closure of large maxillary lip defects. Complications encountered were adequately managed with minimal morbidity and effect on outcome. Buccal transposition flaps can be considered for reconstruction of large maxillary lip defects.
