Functional and aesthetic results obtained by modified Bernard reconstruction technique after tumour excision in lower lip cancers

Background: In this study, we investigated the functional and aesthetic results in new lip formation using modified Bernard reconstruction technique after tumour excision in lower lip cancers. Material and methods: The study included 47 patients. All were operated due to lower labial squamous cell carcinoma and underwent defect reconstruction using modified Bernard technique. The patients were separated into two groups as: 50-70% and 70% total defect occurring after surgical excision. The functional and aesthetic assessments were done after at least 1 year had passed, and the results were compared statistically with a control group. Results: Of the 18 patients with 50-70% defect, sensibility was normal in 16 (89%) and complete competence was determined in all (100%). In 17 patients (94%), complete and symmetric pouting and mouth-opening movements were ensured. Normal mouth opening was noted in all patients. Nasolabial asymmetry was detected in one patient (6%) and apparent mentolabial scar tissue was detected in two patients (11%). The new vermilion was of equal width to the upper lip vermilion in 15 patients (83%). Of the 29 patients with 70% total defect, sensibility was normal in 21 (72%) and complete competence was detected in 27 patients (93%). Sialorrhoea on fluid intake was detected in one patient (3.5%) and sialorrhoea at rest in one patient ( 3.5%). In 22 patients (76%), complete and symmetric pouting and mouth-opening movements were ensured. Normal mouth opening was noted in 27 ( 93%) of the 29 patients. Asymmetry in nasolabial fold was detected in one patient ( 3.5%), apparent scar tissue in nasolabial fold in one patient ( 3.5%) and commissure asymmetry in one patient ( 3.5%). In 25 patients (86%), the new vermilion was of equal width to the upper lip vermilion. No statistically significant difference was found (p > 0.05) among the two patient groups and the control group in terms of functional and aesthetic results. Conclusion: Modified Bernard technique provides a good degree of lip mobility and sensation after excision of lower lip malignant tumour and produces acceptable results. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.