Clinical Study And Retrospective Analysis Of Defect Repair After Resection Of Lower Lip Cancer

BackgroudLower lip cancer is a malignant tumor involving the red lips and the horns of the mouth,mainly squamous cell carcinoma,and relatively few adenocarcinomas.As for the treatment of lower lip cancer,surgical treatment is the first choice clinically.Although more than 200 methods have been used to repair lip defects since 1000 BC,no single method is suitable for all types of lip defects.Therefore,in the actual operation,how to better save and use the remaining tissue,repair the shape of the lower lip,restore the function of the lips,is still a big challenge.Purpose(1)Investigate and analysis the characteristics of age,gender,lesion range,reconstruction method and other characteristics of patients with lower lip cancer.(2)Observe the effect of postoperative lower lip morphology and functional recovery,and provide a basis for a suitable repair program.(3)On the basis of the repair of the lower lip defect,the function and morphology of the lower lip of the patients with lip cancer were restored as much as possible,and summarize the basic principles of surgical treatment after the removal of the lower lip cancer.MethodsSelect the cases of lower lip cancer surgery were performed at Shandong University Stomatological Hospital and Qilu Hospital from August 2016 to October 2018.The gender,age,defect size,and surgical method were recorded.Through comparing the preoperative and postoperative photos,outpatient review,telephone follow-up,etc.to obtain the corresponding information.The surgical outcome was evaluated based on the assessment of the shape and function recovery of the lower lip after surgery and the level of postoperative satisfaction of patients.Results(1)Of the 37 cases of lower lip cancer,24 were males and 13 were females,with a male to female ratio of 1.85:1.The youngest of the total patients was 47 years old,the largest was 93 years old,and the average age was 66 years,10 patients with defect width less than 1/3 after lip cancer resection,10 patients with 1/3 to 1/2 lower lip defect,11 patients with 1/2 to 2/3 lower lip defect,and 6 patients with the defect width greater than 2/3.Seventeen patients were treated with the suture method,5 patients with the Estlander method,11 patients with the modified Bernard method,and 4 patients with the Gillies fan flap.One patient underwent the second phase operation-elongation of the oral fissure.(2)When the defect width is less than one-third,the direct suture method is used,and the postoperative satisfaction is the highest;when the defect width is greater than one-third,less than one-half,the satisfaction of the modified Bernard method and the Estlander flap method is satisfactory.Higher,closer to the corner of the mouth is more inclined to use the Estlander flap method,the direct suture method with poor satisfaction;the defect width is greater than one-half,less than two-thirds,the direct suture method method is poor,using the modified Bernard method satisfaction is high;when the defect width is greater than two-thirds,the patient is more likely to receive the modified Bernard method than the Gillies fan flap.(3)When the width of the lower lip defect is more than 1/3,the patient’s functional satisfaction is poor compared to the shape of the lower lip,who pays more attention to the recovery of the lower lip function.Conclusions(1)Lower lip cancer is more common in men,and the majority of patients are 60~79 years old.(2)Patients with lip cancer are generally older,and they pay more attention to the recovery of postoperative function than aesthetics.(3)The extent of defect after resection of lower lip cancer lesions affects the prognosis of surgery,and should chose personalized surgical design.(4)When the defect width is less than 1/3,the suture method can be used;when the defect width is 1/3 to 1/2,both the modified Bernard method and the Estlander flap method can be used;when the defect width is greater than 1/2,the modified Bernard method can be chosen.