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Comparison of Visor Access Approach with Lower LIP Split Approach in Resection of Oral Cancers

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Purpose

There is high prevalance of oral cancers particularly buccal mucosa and lower gingivobuccal sulcus in our region. These can be approached by both Lower lip split and by Visor approach. Anteriorly placed oral cancers can be resected by visor approach, retaining oral competence and lower lip vascularity. Visor approach is challenging in locally advanced oral cancers requiring reconstruction. We compared outcome of resection of lateralized oral cancers by lower lip split approach and visor approach with regard to duration of surgery, adequacy of exposure of tumour, access for reconstruction, resection margins and complications.

Methodology

66 Patients with T2 & T3 staged oral squamous cancers were randomized into two groups. Following neck dissection, Group A underwent composite resection by lower lip split, and Group B by visor approach. Variables mentioned above were compared between two groups.

Results

This study included patients with T2(58%)and T3 (42%) oral cancers. Except 3 patients in Group B, adequacy of exposure was similar in both groups. Operating time was longer in Group B. Close margins anteriorly were more frequent in Group A. Axial flaps(98.5% ) and radial forearm free flaps(1.5%) were used for reconstruction. Suturing bulky flaps was difficult in Group B( 9.1%).Most common complication in both groups was orocutaneous fistula.

Conclusion

Adequacy of exposure, resected margins, surgical outcome with regards to healing and complications were similar between lower lip split and visor approach in oral cancers. Visor approach for resection of oral cancers is preferred option in tumours close to oral commissure.

Summary

  • Oral cancers particularly buccal mucosa and lower gingivobuccal sulcus in our region and these can be approached by both Lower lip split and by Visor approach.

  • Adequacy of exposure, resected margins, surgical outcome with regards to healing were similar in lower lip split and visor approach.

  • Complications were also similar between lower lip split and visor approach in oral cancers.

  • Visor approach for resection of oral cancers is preferred option in tumors close to oral commissure.

  • Most common complication in both groups was orocutaneous fistula.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of ENT & HNS SDUMC, Kolar, Karnataka, India

    V. Vyshnavi, S. M. Azeem Mohiyuddin & Kouser Mohammadi

Authors
  1. V. Vyshnavi
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  2. S. M. Azeem Mohiyuddin
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  3. Kouser Mohammadi
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Contributions

Dr.Vyshnavi.V: Data collection, preparation of manuscript, Data analysis. Dr.S.M.Azeem Mohiyuddin: Study concept and design, operating surgeon, data analysis and editing of manuscript. Dr.Kouser Mohammadi: Data collection, data analysis and editing of manuscript.

Corresponding author

Correspondence to S. M. Azeem Mohiyuddin.

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Disclosure of Potential Conflicts of Interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Informed Consent

Consent to participate Informed consent was obtained from all individual participants included in the study. Consent for publication Patients signed informed consent regarding publishing their data and photographs.

Ethics Approval

Institutional ethical clearance was obtained before starting the study.(DMC/KLR/IEC/769/2020-21).

Research involving human participants and/or animals

No.

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Vyshnavi, V., Azeem Mohiyuddin, S.M. & Mohammadi, K. Comparison of Visor Access Approach with Lower LIP Split Approach in Resection of Oral Cancers. Indian J Otolaryngol Head Neck Surg 75, 299–305 (2023). https://doi.org/10.1007/s12070-022-03166-2

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  • DOI: https://doi.org/10.1007/s12070-022-03166-2

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