Surgical and functional outcome of extensive resection of upper lip carcinoma

Abstract

Objectives: To evaluate aesthetic and functional outcome of ipsilateral fan flap for upper lip reconstruction after extensive excision of cancerous lesions Patients & methods: The study included 17 patients; 11 males and 6 females with mean age of 64.2±7.1 years; 12 patients had basal cell carcinoma and 5 patients had squameous cell carcinoma and 8 patients had associated morbidities. Surgical resection was performed with safety margin adjusted according to intraoperative print cytology performed for all cases; fan flap was fashioned so as to include the angle of the mouth as the pivot for flap rotation, upper labial advancement flap was prepared for completion of closure of the resultant defect and cheek advancement flap was fashioned for closure of the defect that resulted after fan flap fashioning. All patients underwent functional and aesthetic evaluation including the ability to whistle, blow the cheek and to suckle the tube, and their satisfaction with the circumference of the mouth when fully opened and with the commissural appearance. Results: All patients had primary surgical excision and immediate repair. Operative data included mean safety margin distance of6.9±1.6 mm, mean resultant defect in relation to lip size was 56±6%, mean operative time was 146.2±18.8 min and mean operative blood loss was 266.5±49.7 cc. Five patients had postoperative (PO) surgery-related morbidities for a rate of 29.4%; 3 patients had wound infection with small length wound dehiscence in one patient and 2 patients developed microstomia. Mean PO follow-up period was 27.9±10. 7 months. No cancer or surgery-related mortalities were reported. Mean PO satisfaction score was 10.8±2.4; 5 patients had score 10. Conclusion: Ipsilateral fan with contralateral advancement flaps for upper lip reconstruction after extensive resection for upper lip carcinoma provides acceptable functional and aesthetic outcome.