Abstract
AlloDerm (LifeCell Corporation, Branchburg NJ) is an acellular dermal homograft processed from human cadaveric skin. AlloDerm has been used successfully for soft tissue reconstruction due to its lack of immunogenicity and minimal absorption. In the lip, it has been utilized for aesthetic lip augmentation and as an injectable filler. Description of its usage as an implant in primary lip reconstruction after tumor resection is limited. We describe the case of a 52 year old male with a squamous cell carcinoma of the oral commissure and lower lip. After resection, the defect was reconstructed using implanted AlloDerm for bulk, a buccal mucosal advancement flap, and a cheek rhomboid flap. Lip mobility and oral competence were normal 3 months postoperatively. The reconstruction achieved adequate augmentation without significant resorption. AlloDerm should be considered in primary lip reconstruction after cancer resection.
1
Introduction
AlloDerm (LifeCell Corporation, Branchburg NJ) has been used for soft tissue reconstruction and augmentation since the 1990s . AlloDerm is an acellular cadaveric dermal graft, processed in such a way to remove the epidermal and dermal cells. An acellular matrix of collagen, elastin, and glycosaminoglycans remains, which promotes neovascularization and neoepithelialization . In addition, it is relatively nonimmunogenic, without evidence of rejection or significant resorption . AlloDerm has been used for nasal reconstruction, septal perforations, eyelid reconstruction, and facial soft tissue defects . It has been used as an injectable filler and as an implant for lip augmentation, and as an implant for repairing cleft lip deformities and lower lip repair in Van der Woude syndrome . Description of its usage of an implant in primary lip reconstruction after cancer resection is limited.
2
Case report
The patient is a 58 year old male who presented with a one year history of an enlarging left lower lip and oral commissure squamous cell carcinoma. A preoperative PET/CT noted a 1.1 × 1.3 cm FDG avid lesion in the left lower lip, overlying the buccinator, without any pathologic cervical lymphadenopathy. The tumor was centered in the left oral commissure, with submucosal involvement of 1/3 of the lower lip, small portion of the upper lip, and 1–2 cm of the buccal region ( Fig. 1 A ). After resection ( Fig. 1 B), the defect was reconstructed with a buccal advancement flap, AlloDerm implant, and a cheek rhomboid flap ( Fig. 1 C, D). Lip mobility and oral competence were normal at 3 and 6 month postoperative visits without significant implant resorption ( Fig. 1 E, F).
2
Case report
The patient is a 58 year old male who presented with a one year history of an enlarging left lower lip and oral commissure squamous cell carcinoma. A preoperative PET/CT noted a 1.1 × 1.3 cm FDG avid lesion in the left lower lip, overlying the buccinator, without any pathologic cervical lymphadenopathy. The tumor was centered in the left oral commissure, with submucosal involvement of 1/3 of the lower lip, small portion of the upper lip, and 1–2 cm of the buccal region ( Fig. 1 A ). After resection ( Fig. 1 B), the defect was reconstructed with a buccal advancement flap, AlloDerm implant, and a cheek rhomboid flap ( Fig. 1 C, D). Lip mobility and oral competence were normal at 3 and 6 month postoperative visits without significant implant resorption ( Fig. 1 E, F).
