Squamous Cell Carcinoma of the Lower Lip with Involvement of the Lip Commissure

Clinical Scenario

This protocol applies to squamous cell carcinoma (SCC) arising on the lower lip where the tumor extends to involve the lip commissure — a specific anatomical presentation that directly determines both the excision strategy and the reconstruction technique required.

Key Feature: Commissure Involvement

When the SCC reaches the lip commissure, this finding is a decisive factor in planning. The involvement of the commissure drives the selection of the specific reconstructive approach used following radical tumor removal.

Treatment Goals

The primary clinical aims are achieving healthy (clear) surgical resection margins and ensuring absence of local tumor recurrence.

Surgical Approach partial — full protocol required

Management is carried out under general anesthesia with full-thickness radical excision of the lower lip tumor, with specific safety margin requirements. Because the lip commissure is involved, a dedicated flap reconstruction technique is indicated. Perioperative antimicrobial and analgesic coverage is included. The complete operative sequence, margin criteria, reconstruction steps, and full postoperative regimen are available in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.maxilo.2015.03.006

However, if the lip commissure is involved, a Fries flap should be formed.
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 nasothrachel 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.
The prognosis improves if the margins are healthy and the resection radical.
In our present study, we report no disease recurrences.

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