Statement of the ProblemThe lower lip splitting incision with associated mandibulotomy is widely used in head and neck cancer surgery to provide access to intraoral, pharyngeal and parapharyngeal tumors as well as to the cervical spine. While providing wide access, these incisions have been associated with less appealing esthetic results than combined transoral and cervical approaches that do not violate the lip and orbicularis oris.Materials and MethodsA retrospective review of five years of patients with oral and oropharyngeal malignant and benign tumors treated at the Head and Neck Surgical Associates of Portland, Oregon, which is a maxillofacial surgery unit where avoidance of the lip-spitting mandibulotomy is commonplace, will be described. The situations where lip-splitting mandibulotomy is needed will be discussed, as will those situations where it can be avoided. The literature with respect to functional outcomes and cosmesis with lip splitting mandibulotomy will also be reviewed.Methods of Data AnalysisRetrospective case series.Results of InvestigationCertain factors such as trismus, extensive tumor extension to the tonsillary fossa and prior radiation therapy may require the lip-splitting mandibulotomy approach.ConclusionHead and Neck units with a background in oral and maxillofacial surgery may have an advantage in the application of transoral surgical approaches to the oral/oropharyngeal tumor patient. Improved cosmesis can be achieved by avoidance of the lip splitting mandibulotomy where feasible. Statement of the ProblemThe lower lip splitting incision with associated mandibulotomy is widely used in head and neck cancer surgery to provide access to intraoral, pharyngeal and parapharyngeal tumors as well as to the cervical spine. While providing wide access, these incisions have been associated with less appealing esthetic results than combined transoral and cervical approaches that do not violate the lip and orbicularis oris. The lower lip splitting incision with associated mandibulotomy is widely used in head and neck cancer surgery to provide access to intraoral, pharyngeal and parapharyngeal tumors as well as to the cervical spine. While providing wide access, these incisions have been associated with less appealing esthetic results than combined transoral and cervical approaches that do not violate the lip and orbicularis oris. Materials and MethodsA retrospective review of five years of patients with oral and oropharyngeal malignant and benign tumors treated at the Head and Neck Surgical Associates of Portland, Oregon, which is a maxillofacial surgery unit where avoidance of the lip-spitting mandibulotomy is commonplace, will be described. The situations where lip-splitting mandibulotomy is needed will be discussed, as will those situations where it can be avoided. The literature with respect to functional outcomes and cosmesis with lip splitting mandibulotomy will also be reviewed. A retrospective review of five years of patients with oral and oropharyngeal malignant and benign tumors treated at the Head and Neck Surgical Associates of Portland, Oregon, which is a maxillofacial surgery unit where avoidance of the lip-spitting mandibulotomy is commonplace, will be described. The situations where lip-splitting mandibulotomy is needed will be discussed, as will those situations where it can be avoided. The literature with respect to functional outcomes and cosmesis with lip splitting mandibulotomy will also be reviewed. Methods of Data AnalysisRetrospective case series. Retrospective case series. Results of InvestigationCertain factors such as trismus, extensive tumor extension to the tonsillary fossa and prior radiation therapy may require the lip-splitting mandibulotomy approach. Certain factors such as trismus, extensive tumor extension to the tonsillary fossa and prior radiation therapy may require the lip-splitting mandibulotomy approach. ConclusionHead and Neck units with a background in oral and maxillofacial surgery may have an advantage in the application of transoral surgical approaches to the oral/oropharyngeal tumor patient. Improved cosmesis can be achieved by avoidance of the lip splitting mandibulotomy where feasible. Head and Neck units with a background in oral and maxillofacial surgery may have an advantage in the application of transoral surgical approaches to the oral/oropharyngeal tumor patient. Improved cosmesis can be achieved by avoidance of the lip splitting mandibulotomy where feasible.