Lip Cancer and Reconstruction

Question 1

What is the relationship of the facial artery to the risorius and the buccinator?

Answer 1

Deep to the risorius

Superficial to the buccinator

Question 2

What artery does the superior labial artery give off prior to entering the orbicularis oris?

Answer 2

Angular artery

Question 3

What is the ridge running from the nose to the lip

Answer 3

Philtral ridge

Question 4

What are the purely labial consonants?

Answer 4

b
m
w
p

Question 5

What are the labial dental consonants?

Answer 5

f

v

Question 6

What is the most common location of oral cavity cancer?

Answer 6

Lip

Question 7

Risk factors for lip cancer?

Answer 7

Sun exposure
Male sex
Smoking
Alcohol

Question 8

What is the rule of 90% for lip cancer?

Answer 8

90% on the red lip
90% on the lower lip
90% SCC

Question 9

Does BCC occur more commonly on the upper or lower lip?

Answer 9

Upper lip

Question 10

What is the lymphatic drainage pattern of upper vs lower lip cancers?

Answer 10

Upper: IPSILATERAL level I-III nodes
Lower: IPSILATERAL and CONTRALATERAL level I-III nodes

Question 11

What is the reason that upper lip cancers will not spread to contralateral nodes?

Answer 11

Embrylogical fusion in the midline prevents contralateral spread

Question 12

T staging of lip cancer

Answer 12

T1: <2cm
T2: 2-4 cm
T3 >4 cm
T4: invasion of adj structures (cortical bone, skin, floor of mouth)

Question 13

What size margins are typically needed around lip SCC?

Answer 13

0.5 cm

Question 14

If lip defect includes 1/2 - 2/3 lip and involves oral commisure, what flap should be used?

Answer 14

Estlander flap

Question 15

If lip defect includes 1/2 - 2/3 lip and does not involve oral commisure, what flap should be used?

Answer 15

Abbe flap

Question 16

What flap is for use only in lesions of the red lip and is the favored method for restoration of the vermilion?

Answer 16

Mucosal advancement flap

Question 17

How is a lip mucosal advancement flap performed?

Answer 17

Undermining of the labial mucosa deep to the minor salivary glands and superficial to the posterior aspect of the orbicularis

Question 18

What is the arterial supply of the Abbe flap?

Answer 18

Superior or inferior labial artery, depending on the defect **can not include the commisure

Question 19

How big should the Abbe flap be drawn?

Answer 19

Half the width of the defect on the opposite lip

Question 20

How long until an Abbe flap pedicle can be divided?

Answer 20

14-21 days