Lower lip cancer treated with extended bilateral Karapandzic flaps reconstruction and simultaneous cervical lymph node dissection

Abstract

Several techniques have been reported for the reconstruction of total defects of the lower lip. However, the most effective method for total or subtotal resection of the lower lip remains controversial. The Karapandzic flap is commonly used for middle to large defects of the lower lip, although it does not introduce new tissue into the oral cavity and may result in postoperative microstomia. We present the case of a 73-year-old Japanese female with a lower lip tumor occupying 80% of the lower lip, confirmed by biopsy as well-differentiated squamous cell carcinoma. Imaging showed a 50mm tumor in diameter in the lower lip and multiple right-sided cervical lymphadenopathy. The tumor was excised and reconstruction was performed with bilateral extended Karapandzic flaps, along with simultaneous cervical lymph node neck dissection, with preservation of the feeding facial artery. The patient made an uneventful postoperative recovery, and two years after surgery both appearance and function of the lower lip were satisfactory. Our findings suggest that the use of bilateral extended Karapandzic flaps may be a viable option for total defects of the lower lip and simultaneous neck dissection is possible when the feeding facial artery is preserved.