Guidance flap choice for lip cancer: Principles, timing and esthetic-functional results

Abstract

The purpose of this study is to help in the choice of an appropriate reconstructive technique by reference to the dimensions of the defect, the required functional and esthetic outcomes, and retention of adequate surgical safety margins to prevent primary tumor recurrence. Material and methodsA total of 158 patients were treated. We indicate how the most appropriate reconstructive method may be chosen, with reference to the size and position of the cancer and depth of tissue infiltration. ResultOf all patients, 89 (56.3%) had T1 (lesions up to 2cm long, less than 1/3). The remaining patients had T2 lesions >2cm, from 1/3 to 2/3 of lip involvement (50 patients), T3 lesions>4cm, more than 2/3 of lip involvement (18), and a T4 lesion>5.5cm with commissure involvement (1). ConclusionWe share the widespread view that a surgeon who performs a reconstruction using the minimal tissue components required to close the lesion will achieve the best results. Reconstruction does not influence prognosis and overall should be oriented to the defect. Careful, clean, and safe resection of lip carcinoma, with creation of healthy margins, can be followed by functional and esthetic lip reconstruction.