Functional and Aesthetic Outcome of Macgregor and Z Plasty (Step Ladder) Approach for Lip Splitting in Oral Squamous Cell Carcinoma.

Abstract

The aim of the study is to compare the functional and esthetic results of two lip splitting approaches-McGregor incision and stepladder Z plasty for surgical resection of primary Oral Squamous cell carcinoma (OSCC). Prospective study involved 24 patients who had modified radical neck dissection for OSCC between 2018 and 2020. Predictor variables were drawn from demographic characteristics (age and gender), primary site, extent of the primary lesion. Patients were divided into two groups randomly with group I McGregor lip splitting incision and group II step ladder Z plasty, with subjective and objective assessment. In the overall comparison of the oral incontinence between the two groups, there was no statistically significant results. Z plasty group had better outcome with lesser degree of drooling and good cosmesis. There was no difference between the speech efficiency between the two groups. Subjective assessment of the appearance of lips and face was better in Z plasty group. Subjective assessment of inversion and eversion was better in McGregor group. Cosmesis was assessed objectively by Stony Brook Scar Evaluation Scale (SBSES). Group 1 had a mean score of 2.92 out of 5 and Group II mean score of 4.08 out of 5. Cosmesis was better in Z plasty group. Z plasty was found as a superior option when it comes to cosmesis due to its geometric nature which allows accurate approximation. McGregor offers better functional outcome in terms of lip movement and oral incontinence.