A comparison of aesthetic, functional and patient subjective outcomes following lip-split mandibulotomy and mandibular lingual releasing access procedures

J. Devine, S. Rogers, D. McNally, J. Brown, E. Vaughan

Research output: Contribution to journalArticle

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Abstract

Good access to the site of oral cancer is essential to allow for adequate three-dimensional resection of the tumour. Splitting the lower lip in conjunction with a mandibulotomy offers excellent access to all areas of the mouth and pharynx, but this inevitably produces a facial scar and there is morbidity associated with the healing of the mandibulotomy. An alternative approach is the mandibular lingual releasing technique, which provides good access to the oral cavity and avoids the morbidity associated with lip-split mandibulotomy. The aim of this study was to compare aesthetic, functional and patient subjective outcomes between the two access procedures. One hundred and fifty patients had oral access procedures between 1992–95 (ninety lip-split mandibulotomy and sixty mandibular lingual release). Thirty patients fulfilled selection criteria (primary surgery as treatment, tumour size <5.1 cm, anterior oral cavity tumours, and reconstructed with a radial forearm free flap) and 10 patients from each group were able to attend a review appointment for objective clinical assessment of their speech, tongue mobility, lip competence and temperomandibular signs. Using items from the University of Washington quality of life questionnaire patient subjective outcomes were assessed. Using standardised photographs the clinician and lay persons assessed the overall post-operative facial appearance. The patients also assessed their own facial appearance using a similar scoring method. Resection margins were similar in both groups and it would seem that both methods provide adequate access to the anterior oral cavity. Clinical examination showed no differences in function between the two access procedures. Although there was a small number, the lip-split mandibulotomy group reported significantly better speech, swallowing and chewing. Previous concerns about a possible detrimental effect on appearance following lip-split, were not borne out in this study.
Original languageEnglish
Pages (from-to)199-204
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume30
Issue number3
DOIs
Publication statusPublished - Jun 2001

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Lip
Esthetics
Tongue
Mouth
Patient Selection
Morbidity
Neoplasms
Free Tissue Flaps
Mouth Neoplasms
Mastication
Deglutition
Pharynx
Forearm
Mental Competency
Cicatrix
Appointments and Schedules
Research Design
Quality of Life

Cite this

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title = "A comparison of aesthetic, functional and patient subjective outcomes following lip-split mandibulotomy and mandibular lingual releasing access procedures",
abstract = "Good access to the site of oral cancer is essential to allow for adequate three-dimensional resection of the tumour. Splitting the lower lip in conjunction with a mandibulotomy offers excellent access to all areas of the mouth and pharynx, but this inevitably produces a facial scar and there is morbidity associated with the healing of the mandibulotomy. An alternative approach is the mandibular lingual releasing technique, which provides good access to the oral cavity and avoids the morbidity associated with lip-split mandibulotomy. The aim of this study was to compare aesthetic, functional and patient subjective outcomes between the two access procedures. One hundred and fifty patients had oral access procedures between 1992–95 (ninety lip-split mandibulotomy and sixty mandibular lingual release). Thirty patients fulfilled selection criteria (primary surgery as treatment, tumour size <5.1 cm, anterior oral cavity tumours, and reconstructed with a radial forearm free flap) and 10 patients from each group were able to attend a review appointment for objective clinical assessment of their speech, tongue mobility, lip competence and temperomandibular signs. Using items from the University of Washington quality of life questionnaire patient subjective outcomes were assessed. Using standardised photographs the clinician and lay persons assessed the overall post-operative facial appearance. The patients also assessed their own facial appearance using a similar scoring method. Resection margins were similar in both groups and it would seem that both methods provide adequate access to the anterior oral cavity. Clinical examination showed no differences in function between the two access procedures. Although there was a small number, the lip-split mandibulotomy group reported significantly better speech, swallowing and chewing. Previous concerns about a possible detrimental effect on appearance following lip-split, were not borne out in this study.",
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A comparison of aesthetic, functional and patient subjective outcomes following lip-split mandibulotomy and mandibular lingual releasing access procedures. / Devine, J.; Rogers, S.; McNally, D.; Brown, J.; Vaughan, E.

In: International Journal of Oral and Maxillofacial Surgery, Vol. 30, No. 3, 06.2001, p. 199-204.

Research output: Contribution to journalArticle

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