New modification of the mandibulotomy approach without lip splitting.
BACKGROUND
A lower lip-splitting incision has traditionally been performed with different types of mandibulotomy approaches for obtaining wide access to oral and oropharyngeal cancers. However, lip splitting can be associated with unfavorable aesthetic results. We describe our new modification of a traditional mandibulotomy approach without lip splitting to avoid these morbidities. This is a case series in a tertiary referral center.


METHODS
The primary tumor site was the oropharynx in four cases, the oral cavity in two cases, and the parapharynx in one case. Each case was assessed for TNM staging, perioperative complications, status of the resection margins, tumor recurrence, and the aesthetic and functional results of the lower lip.


RESULTS
All the tumors were safely removed by means of our modified non-lip-splitting mandibulotomy approach through the combined intraoral and transcervical routes with adequate resection margins. There were no troublesome difficulties in reconstruction of the surgical defects with various major flaps. The cosmetic results were excellent with intact lip function.


CONCLUSIONS
We believe this new modified non-lip-splitting mandibulotomy approach could replace the conventional mandibulotomy approach for some selected malignant lesions, with excellent cosmetic and functional results of the lower lip.
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong, Kangnam-Gu, Seoul, 135-710, Korea. chbaek@smc.samsung.co.kr
Chung-Hwan
CH
Baek
Seung-Won
SW
Lee
Han-Sin
HS
Jeong
D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002648:Child; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010157:Palatal Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014062:Tongue Neoplasms / Q000601:surgery; D014067:Tonsillar Neoplasms / Q000601:surgery