The modified vermilion border-marionette line approach: A management for buccal cancer with wider indications and higher satisfaction.

Abstract

The purpose of this study is to explore the effects of modified vermilion border-marionette line (MVBML) approach on postoperative facial scar, nerves injury, and prognosis of patients with buccal squamous cell carcinoma (BSCC). This is a single-center, prospective cohort study that enrolled 80 patients with BSCC from June 2015 to December 2020. According to the different surgical approaches, the patients were divided into two groups: the lower lip median (LLM) approach group and the MVBML approach group. The results showed that the appearance (p=0.003), scar consciousness (p < 0.001) and satisfaction with appearance (p=0.001) of patients in the MVBML group were significantly better than those in the LLM group, and the difference was more obvious in elderly group. Statistical analysis of postoperative nerves injury showed that the MVBML group had a lower risk of facial and mental nerves injury than the LLM group, and there was a significant statistical difference in mental nerve injury between the two groups (p < 0.001). Through Kaplan-Meier survival analysis, we found no significant difference in disease-specific survival (p=0.47) or disease-free survival (p=0.70) between the LLM approach group and the MVBML approach group. The MVBML surgical approach is worthy of advancement for the surgical treatment of BSCC.