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Comparison of approaches for oral cavity cancer resection: lip-split versus visor flap
Benjamin W Cilento1, Mark Izzard, Ernest A Weymuller
1Hedgewood Surgical Center, Facial Plastic and Reconstructive Surgery, New Orleans, LA 70130, USA.
Objective:
To compare lip-split and visor flap approaches to the oral cavity in terms of morbidity, margins, and locoregional recurrence.
Design And Setting:
Retrospective case series at the University of Washington, Seattle.
Methods:
Seventy patients undergoing resection of advanced (T4) anterior oral cavity squamous cell carcinoma requiring fibula reconstruction were grouped according to surgical access procedure performed (lip-split [LS] or visor flap [VF]). Data on surgical morbidity, margin status, and outcomes were compared.
Results:
Recurrence rates and positive margins were similar for both groups. Rates of postoperative fistulae were 6.8% (LS) vs 0% (VF) and for oral incompetence 14.6% (LS) vs 6.9% (VF). Most of the fistulas (37.5%) were in irradiated patients. Neither group had any malunions.
Conclusions:
There is no significant difference in pathological margins or rates of local recurrence when using either the lip-split or the visor approach. The lip-split approach has a higher rate of postoperative fistula formation than the visor flap approach; fistula formation may be associated with previous irradiation.
