The Abbé-Estlander flap surgery is a cross-lip procedure that is valuable in repairing a defect on the lower lip using a full-thickness flap, consisting of the skin, muscle and mucosa, from the upper lip. As usefulness and practicality of the flap in reconstruction of lower lip surgical defects in Asian ethnicity have not been documented, the authors present a case of successful lower lip reconstruction with a staged, Abbé-Estlander lip switching flap with commissuroplasty as an illustrative example. A 71-year-old male has presented with an ulcerating lip nodule in the middle one third of the lower lip, measuring about 1.5×2 cm across its long and short axes. Wide excision of the tumor was followed by delineation of the triangular Abbé-Estlander flap from the upper lip, in which the medial hinge point of the base was chosen as the pedicle. Then, the flap elevation was carried out from the lateral commissure and then was transferred into the lower lip defect. Three weeks later, commissuroplasty was performed to correct the rounding at the new commissure. The patient is currently performing his daily activities with no apparent compromise in orbicularis oris strength or oral continence. Given the size of the primary defect and the flap-to-defect ratio of size, the degree of microstomia was acceptable. Even with other myriad of reconstructive options at surgeons' disposal, the Abbé-Estlander lip-switching flap is a reliable, and less morbid method of lower lip reconstruction for Asian surgical candidates. The authors illustrate an exemplary case in which a relatively large lower lip defect was successfully repaired using an upper lip flap of a significantly smaller size in an Asian subject of advanced age, without any remarkable long term sequelae which have traditionally been associated with the trans-oral lip switching flap technique.
Aged ; Asian Continental Ancestry Group ; Humans ; Lip Neoplasms ; Lip* ; Male ; Methods ; Microstomia ; Mucous Membrane ; Skin ; Ulcer

Squamous cell carcinoma (SCC) of the lower lip is the most common malignant tumor, comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. After resection, reconstruction is important both aesthetically and functionally, because the lower lip is a prominent location in the face and it is where essential functions of the sphincter are carried out as in assisting mastication, swallowing, phonation, and expressing emotion. Depending on the location and size of the tumor, different types of flaps are used. We describe here a successful technique to reconstruct a large lower lip defect using a submental island flap and a mucosal flap for patients.
Carcinoma, Squamous Cell ; Deglutition ; Humans ; Lip ; Lip Neoplasms ; Mastication ; Phonation ; Surgical Flaps ; Ulcer

Lip cancer is the most common malignancy of the oral cavity and is the second most common cancer in the head and neck. Because lip cancer can be detected early, it is readily curable compared with other head and neck malignancies. In the treatment, surgery is recommended for most patients. After resection, reconstruction is important both aesthetically and functionally, because of it's prominent location of face and essential functions of sphincter to assist in mastication, swallowing, phonation, and expressing emotion. Recently, we performed the reconstruction of lower lip defects after resection of cancer using various methods and achieved good results. So we present the cases with a review of literatures.
Carcinoma, Squamous Cell ; Deglutition ; Head ; Humans ; Lip ; Lip Neoplasms ; Mastication ; Mouth ; Neck ; Phonation ; Reconstructive Surgical Procedures

BACKGROUND: Because there are numerous methods for reconstruction of the lower lip, it is not easy to choose the optimal method. In choosing the surgical method for lower lip reconstruction, we obtained acceptable outcomes based on our treatment strategy, which included either a barrel-shaped excision or the Webster modification of the Bernard operation. We report on the surgical outcomes based on our treatment strategy. METHODS: This study included 26 patients who underwent lower lip reconstructive surgery from September 1996 to September 2010. The operation was done using either a barrel-shaped excision or the Webster modification, considering the location of the defect, the size of the defect, and the amount of residual tissue on the lateral side of the vermilion after excision. RESULTS: In our series, 3 patients underwent a single barrel-shaped excision, and nine patients underwent a double barrel-shaped excision. In addition, the unilateral Webster modification was performed on in 6 patients, and there were eight cases of bilateral Webster modification. All of the patients except one were satisfied with the postoperative shape of the lip. In one case both recurrence and dehiscence occurred. One patient had a good postoperative lip shape, but had difficulty wearing a denture, and also underwent commissuroplasty. Furthermore, there were two patients who complained of drooling, and 4 with paresthesia. CONCLUSIONS: A soft tissue defect resulting from wide excision of a lower lip malignancy can be successfully reconstructed using only one of two surgical methods: the barrel-shaped excision or the Webster modification of the Bernard operation.
Dentures ; Facial Neoplasms ; Humans ; Lip ; Reconstructive Surgical Procedures ; Recurrence ; Sialorrhea

OBJECTIVE: To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection. METHODS: Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication. RESULTS: During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed. CONCLUSIONS Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
Facial Nerve ; Humans ; Lip ; Maxilla ; Maxillary Neoplasms ; Surgical Flaps

Pilar sheath acanthoma is a rare, benign follicular hamartoma commonly affecting middle-aged and elderly individuals. It is characterized by a small, solitary, skin-colored papule situated on the head and neck, particularly around the upper lip. The lesion shares some features with trichofolliculoma and dilated pore of Winer, so it should be differentiated from these. Cytokeratin (CK) is a useful marker for studying the origin of epithelial tumors. We report a case of pilar sheath acanthoma which originated from outer root sheath using CK.
Acanthoma ; Aged ; Follicular Cyst ; Hamartoma ; Head ; Humans ; Keratins ; Lip ; Neck ; Neoplasms, Basal Cell ; Skin Neoplasms

When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident(R) denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.
Adhesives* ; Crowns ; Denture, Complete* ; Denture, Partial, Removable* ; Dentures* ; Friction ; Humans ; Jaw ; Lip ; Lip Neoplasms* ; Mandible ; Mouth Neoplasms ; Necrosis ; Periodontitis* ; Radiotherapy ; Root Caries ; Tooth

A 77-year old man presented with a fungating mass on the oral mucosa and lip, which had an irregular margin. An incisional biopsy of the mass revealed an invasive squamous cell carcinoma. PCR analysis detected HPV DNA in the biopsy specimen. The HPV type was determined as HPV-53 by direct cycle sequencing. This is the first report of HPV-53 in an oral malignant tumor.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; DNA ; Humans ; Lip ; Mouth Mucosa* ; Mouth Neoplasms ; Polymerase Chain Reaction

The new onset of acanthosis nigricans in an adult-especially when the lesions appear on mucosal membranes such as the lips, periocular areas, and anus-may be indicative of an underlying tumor. Adenocarcinoma of the gastrointestinal tract is the most common malignancy-most often cancer of the stomach. A 72 years old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 12 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy. The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Aged ; Female ; Gastrointestinal Tract ; Humans ; Hypertrophy ; Lip ; Membranes ; Pigmentation ; Stomach Neoplasms

A 44-year-old woman underwent a breast cancer operation under general anesthesia. We performed bronchoscope guided intubation along with a jaw thrust maneuver on the patient to achieve a good visual field. The patient complained of left lower lip weakness after the operation. The lower lip of the patient was deviated to the right. The cause might have been a temporary compression of the left facial nerve at the mandibular angle during performance of the jaw thrust maneuver. Fortunately, the patient's palsy recovered completely during the following one month. We report here on a case of transient facial nerve palsy after general anesthesia, and this occurred despite performing a very short duration of jaw thrust.
Adult ; Anesthesia, General ; Breast Neoplasms ; Bronchoscopes ; Facial Nerve ; Female ; Humans ; Intubation ; Jaw ; Lip ; Paralysis ; Visual Fields