Modified submandibular mandibulotomy approach without lip-splitting in tongue cancer

Lip-splitting approach for oncologic resection and defect reconstruction of tongue squamous cell carcinoma (TSCC) needs modification to avoid unfavorable esthetic results. Forty-three patients with TSCC underwent surgery using the modified submandibular mandibulotomy(MSMM) approach without lip-splitting and another matched 43 patients using lip-splitting mandibulotomy (LSM) approach were reviewed retrospectively. Clinical outcomes evaluation consisted of tumor exposure, resection margin, surgical morbidity, locoregional recurrence, survival status, scar scores and quality of life (QOL). All the tumors were en bolc removed by MSMM approach and LSM approach through combined intraoral routes with excellent tumor exposure and R0 resection margins. Tumor recurrence rates and swallowing, chewing, speech were similar in both groups. The MSMM approach was associated with significantly better facial appearance and recreation than LSM approach. The MSMM approach without lip-splitting is safe and effective, achieves better QOL compared to LSM approach in patients with TSCC.