{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:28:14Z","timestamp":1794245294284,"version":"4.9.0"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Oral modiolus reconstruction is important in unilateral oral commissure removal including the modiolus. However, the proper procedure is not yet established. We performed free\u2010flap reconstruction for full\u2010thickness oral defects involving the oral commissure combined with oral modiolus reconstruction using a fascial sling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>From 2008 to 2018, six oral carcinoma patients, aged 65 to 86\u2009years, underwent free\u2010flap modiolus reconstruction after tumor resection. The resulting lip defects of 10% to 80% were labial (two patients), buccal (two patients), and mixed (two patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five anterolateral thigh flaps including one perforator and one radial forearm flap were performed. The oral defects were covered with folded flaps (size, 11\u2009\u00d7\u20096\u201318\u2009\u00d7\u20097.5 cm<jats:sup>2<\/jats:sup>). The orbicularis oris stumps were connected to the masseter with a fascia lata or palmaris longus tendon (length, 15\u201320\u2009cm), arranged in a Y\u2010shape in four patients and a V\u2010shape in two patients. All the flaps survived without complications. Almost all the patients achieved good oral static effects (lip deviation and drooping) and dynamic effects (mouth opening, oral commissure narrowing, and diet) in the 6 to 65\u2009months' follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Free\u2010flap reconstruction combined with oral modiolus reconstruction using a fascial sling achieves good oral static and dynamic effects for full\u2010thickness oral reconstruction involving the oral commissure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30546","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T13:25:31Z","timestamp":1577107531000},"page":"553-560","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Free\u2010flap reconstruction for full\u2010thickness oral defects involving the oral commissure combined with oral modiolus reconstruction using a fascial sling"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5837-3980","authenticated-orcid":false,"given":"Kaoru","family":"Sasaki","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Aihara","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Nishijima","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Sekido","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Tsukuba  Tsukuba 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