“Bandoneon” Technique: Mucomyocutaneous Stretched Flaps in Lip Reconstruction
I. J. PELED
Y. ULLMANN
EDITORIAL COMMENT
The innovative nomenclature of this flap is appropriate in that the musical instrument called a bandoneon is like an accordion that stretches and contracts as required. The authors have used this principle in stretching the tissue for lip reconstruction.
Up to two thirds of the lip can be repaired by using a mucomyocutaneous flap in the remaining lip, which is stretched as a “bandoneon,” following a zigzag release incision (Fig. 167.1). Results are quite satisfactory, with no alteration of the commissure, no significant decrease of mouth opening, and well-located scars.
INDICATIONS
Tumors of the lip are quite frequent, especially squamous cell carcinomas. The best treatment is adequate surgical excision, with immediate repair of the defect. Depending on the remaining defect after tumor excision, the choice can be as simple as direct suture, or more sophisticated techniques may be required. The flap described here is suitable for the repair of rather large defects in partial reconstruction of the lip using one or two mucomyocutaneous flaps of the remaining lip in a single-stage procedure. Following wide excision of the tumor and frozen sections of the borders, the remaining defect, from one third to two thirds of the lip, is reconstructed by the bandoneon technique.
Other reports have described use of this procedure for the vermilion only (1, 2) or for lip reconstruction without incising the mucosa (3). Some techniques leave unacceptable scarring and may alter the angle of the mouth (4, 5).
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