• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.52-57
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• 1996

Since the upper lip does not receive direct actinic radiation, only 5% of lip tumors develop in the upper lip, while the lower lip is the site of the remainder. Among the lower lip cancer, squamous cell carcinoma is the most common tumor, especially the vermillion border of lower lip is the most common site. The aims of reconstruction of the lip are both aesthetic effect and functional restoration and the ideal procedure must produce a aesthetically normal, not-tao-tight lip and a good sensation and muscle tone of the lip. We have a satisfactory reconstruction of a subtotal loss of lower lip after squamous cell carcinoma extirpation using Gillies fan flap and the case is presented with reviewing a many published reports.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.292-296
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• 2023

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

• Journal of Oral Medicine and Pain
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• v.39 no.2
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• pp.78-81
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• 2014

Verrucous carcinoma is a relatively rare variant of well differentiated squamous cell carcinoma first described by Ackerman in 1948. It is distinct in its slow progression, exophytic cauliflower like growth, low grade malignancy and low incidence of metastasis. The oral cavity is one of the predilection sites for verrucous carcinoma. In the oral cavity, the gingiva and buccal mucosa are the common site. Verrucous carcinoma of the lip is clinically quite rare and only several cases of that were reported in the world. The aim of this study is to report an unusual case of verrucous carcinoma of the lower lip.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.185-188
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• 2000

The goals of lip reconstruction are to provide oral competence, adequate support for the lower lip, contour restoration, adequate lip sulcus, and adequate oral aperture. The composite radial forearm palmaris longus free flap is thin enough that it can be folded onto itself without a significant increase in bulk. The flap is easy to dissect, the pedicle contains long vessels of large diameter, and the skin is a good color and texture match for the perioral region. Moreover, the vascularized tendon can be used for lower lip reconstruction. This makes the flap ideally suited for total lower lip reconstruction. We experienced the case of total lower lip excision and reconstruction with the radial forearm free flap including palmaris longus tendon, so we reported that case with literature. The patient has a lower lip squamous carcinoma(T3NIM0), and performed a total lower lip excision with right modified radical neck dissection and left extended supraomohyoid neck dissection, and a reconstruction with radial forearm free flap includng palmaris longus tendon. The oral competence and masticatory function were nearly normalized and cosmetical result was very acceptable.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.33-36
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• 2022

Squamous cell carcinoma is the most common cancer occurring in the oral cavity and oncologic wide cancer excision is a major cause of large lip defects. Large lower lip defect reconstruction with good functional and aesthetic results has always presented a challenge for plastic surgeons. There are various lower lip reconstruction methods depending on its size, location, and surgeon's expertise. This is a case of a large defect spanning more than two-thirds of the lower lip after wide excision due to squamous cell carcinoma. The Karapandzic flap was used to reconstruct the defect with a commissuroplasty carried out in a second operation, which yielded a relatively good functional and aesthetic result. No recurrences or metastases were observed within a one year follow-up period.

• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.324-328
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• 2021

Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient's oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.23-26
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• 2023

Lower lip reconstruction in cases with a full-thickness defect over one-third of the vermilion is challenging. Numerous conventional techniques have been applied with unsatisfactory surgical outcomes because of microstomia and oral commissure blunting due to shortened horizontal lip length. Herein, we present a case in which a full-thickness lower lip defect of more than one-third of the horizontal lip length was covered with a novel mucosal roofing flap reconstruction to minimize the loss of horizontal lip length and to preserve mouth opening. No recurrences or metastases were observed during 3 years and 6 months of follow-up, with horizontal lower lip length maintained and mouth opening of 2.5 finger breadths.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.4
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• pp.361-365
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• 2007

The reconstruction of perioral defects following resection of cancer on the perioral region has been a challenge for oral and maxillofacial surgeons. Surgical management of oral squamous cell carcinoma (SCC) typically involves resection of the carcinoma with a 1cm margin of normal appearing tissue. A large surgical defect is often encountered. The goals of perioral reconstruction are esthetics and function, with oral competence and good lip control. Abbe described the operation that bears his name in 1898, when he reported on the repair of a "conspicuous deformity" in a 21-year-old man born with bilateral cleft lip and palate. Since that time, Abbe flap reconstruction has been used more frequently for repair following resection of malignancies. Large defects of the lips have been repaired with recent modifications of the Abbe flap. The technique has been popularized by Estlander for reconstruction of the lower lip. We have treated 70-year-old male patient with SCC on lower lip using Abbe-Estlander flap. Postoperatively the results showed good prognosis. So we report the result of its treatment and case with review of literatures.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.109-112
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• 2009

Purpose: Squamous cell carcinoma(SCC) of the lower lip is the most common malignant tumor comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is of an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. Depending on the location and size of the tumor, different types of flaps are used. We used new method - 'both buccal mucosa transposition flap' for the reconstruction of the near total mucosal defect of the lower lip. Methods: This 67 - year - old men presented with the crusted $1cm{\times}1cm$ sized ulceration of the lower lip that was arised 30 years ago. There were no size and color change, except the bleeding and ulceration. At first, We diagnosed the SCC through the incisinal biopsy. Then We performed the wide excision of the tumor and reconstruction of the lower lip. After the excision of the whole tumor, the defect was measured at $8cm{\times}3.5cm$. We designed the buccal mucosa transposition flap taking care to avoid the parotid duct. The flap was made in a triangular shape for the reconstruction of defected lower lip. The donor site defect can be sutured primarily. Results: A patient in this study had no postoperative complications such as necrosis, dehiscence, infection of the flap or donor site. Reconstructed lower lip is relatively close to that of the natural lip; More satisfactory aesthetic and functional results can be obtained by using this technique rather than other techniques. Conclusion: 'Both buccal mucosa transposition flap' is reliable method for the reconstruction of the large lower lip mucosal defect. The operation is simple and performed in one stage, with no postoperative complications. This technique can offer consistently good functional and esthetic outcomes after reconstruction of lower lip mucosal defect.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5187-5190
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• 2015

This study aimed to investigate the correlation between ${\beta}$-catenin immunoexpression and histopathological grades of lower lip squamous cell carcinoma (LSCC). $\beta$-Catenin abnormal expression was found in 29% of the squamous cells of well differentiated LSCC, 63% of moderately differentiated and 86% of poorly differentiated, and therefor was significantly associated with histological grade (p=0.000). Nuclear $\beta$-catenin expression appeared in 5% of the cells and was also correlated with the histological grades (p=0.000). In 14.7% of the cells it was localized in the cytoplasm, again correlating with histology (p=0.002). According to this study the expression of $\beta$-catenin is an independent prognostic factor for histological grade and to the tumor differentiation. This appears to reflect a structural association and the role of $\beta$-catenin in tumor progression.