Comparison of approaches for oral cavity cancer resection: Lip-split versus visor flap

Abstract

OBJECTIVETo compare lip‐split and visor flap approaches to the oral cavity in terms of morbidity, margins, and locoregional recurrence.DESIGN AND SETTINGRetrospective case series at the University of Washington, Seattle.METHODSSeventy patients undergoing resection of advanced (T4) anterior oral cavity squamous cell carcinoma requiring fibula reconstruction were grouped according to surgical access procedure performed (lip‐split [LS] or visor flap [VF]). Data on surgical morbidity, margin status, and outcomes were compared.RESULTSRecurrence rates and positive margins were similar for both groups. Rates of postoperative fistulae were 6.8% (LS) vs 0% (VF) and for oral incompetence 14.6% (LS) vs 6.9% (VF). Most of the fistulas (37.5%) were in irradiated patients. Neither group had any malunions.CONCLUSIONSThere is no significant difference in pathological margins or rates of local recurrence when using either the lip‐split or the visor approach. The lip‐split approach has a higher rate of postoperative fistula formation than the visor flap approach; fistula formation may be associated with previous irradiation.