Functional and aesthetic outcome of different technique for lip reconstruction after ablative surgery of lip carcinoma at a comprehensive cancer care center in Nepal

Abstract

When treating carcinoma of the lip, surgical excision often becomes necessary to remove cancerous tissue, which subsequently requires reconstructive surgery to restore both functional integrities, like speech and swallowing, and aesthetic desirability as the lip is a prominent facial feature. Different flap techniques are employed depending on the size, location, and extent of the resection.To evaluate the functional & aesthetic outcome of different techniques used in lip reconstruction after lip cancer ablative surgery. A retrospective review of all patients undergoing lip reconstruction using various techniques after lip cancer ablative surgery between 2021 and 2023 were conducted at a tertiary cancer hospital. Descriptive analysis was done. Out of 17 patients, 12 were men and five were women. The mean age was 52.23 years. Out of 17 patients, primary closure using W-plasty and V-plasty technique was used in four patients, lip & commissure by Zisser Flap in one patient, lip advancement and Karapandzic flap in three patients, Bilateral Webster Bernard Flap in one patient, nasolabial flap in patients, Bilobed Pectoralis Major Myocutaneous Flap in one patient, free radial artery forearm flap with palmaris tendon in two patients, Free Anterolateral thigh Flap in two patients and lip & mandibular reconstruction with Free Fibula Osteocutaneous flap in one patient. Oral competence was present in 15 cases and only two patients having minimal incompetence those reconstructed with anterolateral and Radial artery forearm free Flap. Aesthetic outcome was excellent in seven cases, good in six cases and satisfactory in four cases. In one case, minor wound dehiscence was present that healed spontaneously and one had seroma that resolved with serial needle aspiration. Minor grade microstoma was observed in four cases and speech problem in three cases which was minimal in severity.Successful reconstruction of all type of lip defects can be attained, if as many reconstructive procedures as possible have been mastered, and an appropriate technique is used according to the lip defect.