سرطان الشفة السفلى مع آفة أكبر تستلزم إعادة البناء

DOI: 10.1017/S0022215116000499

• Small lesions invading into the adjacent muscle are amenable to a wedge excision.
• The excision can also be completed using a 'W' plasty or half 'W' plasty to avoid the inferior aspect of the excision encroaching on the crease line of the chin.
• If the dimensions of the lip resection require the introduction of tissue to minimise functional problems and microstomia, then this may be by means of Abbe, Abbe-Estlander or Karapandzic flaps.
• The Karapandzic flap is useful for defects involving more than two-thirds of the lower lip, where the defect is in the midline.
• With larger defects of the lower lip reconstruction requires either large cheek flaps to be advanced to repair the defect or the use of free tissue transfer.
• The common forms of cheek flap include the bilateral Gillies fan flaps or the Bernard–Webster cheek flap reconstruction.
• Neck dissection is generally not performed in the absence of clinically suspicious cervical lymph nodes as more than 5 per cent of patients are likely to develop recurrence in the neck following treatment of the primary lesion.