title: Comparison of approaches for oral cavity cancer resection: lip-split versus visor flap.
abstract: OBJECTIVE
  To compare lip-split and visor flap approaches to the oral cavity in terms of morbidity, margins, and locoregional recurrence.
  
  
  METHODS
  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.
authors.affiliation: Hedgewood Surgical Center, Facial Plastic and Reconstructive Surgery, New Orleans, LA 70130, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Cilento
authors.forename: Mark
authors.initials: M
authors.lastname: Izzard
authors.forename: Ernest A
authors.initials: EA
authors.lastname: Weymuller
authors.forename: Neal
authors.initials: N
authors.lastname: Futran
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome