When squamous cell carcinoma of the lower lip extends to involve the full extent of the lip together with neighbouring structures, a dedicated surgical protocol applies. This page outlines the clinical context and the broad therapeutic approach; the complete structured regimen is accessible below.
Clinical scenario: Squamous cell carcinoma of the lower lip measuring ≥5 cm (T4 stage) with involvement of the entire lower lip and contiguous structures — upper lip, oral commissure, and/or cheek. The extent of locoregional spread places this in the most advanced local-stage category requiring a full reconstructive approach after tumour removal.
Closure of the defect with healthy (clear) surgical resection margins and absence of local tumour recurrence.
DOI: 10.1016/j.maxilo.2015.03.006
In one patient with squamous cell carcinoma affecting many adjacent structures (T4), a pectoralis flap was constructed to close the defect, with minimal attention being paid to esthetics or functionality.
It was imperative that each lesion be radically excised, leaving an adequate safety margin on all sides (always 6–10 mm if margins were not examined by a pathologist working in the operating theater, and 3 mm otherwise).
Other patients were treated under general anesthesia with nasotracheal intubation.
All patients received antibiotics (1 g amoxicillin and 1 g clavulanic acid every 12 h for 4 days).
On request, patients were also given paracetamol 1 g three times daily or ibuprofen 600 mg three times daily.
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