Experience of Secondary Commissuroplasty for Lip Morphology and Function after Lip Reconstruction

Abstract

Patients who have undergone lip reconstruction due to oral cancer often develop deformities of the oral commissure on the affected side. We report our experience with two cases of secondary commissuroplasty for lip morphology and function after lip reconstruction.

Case report

Case 1
54-year-old male. He was referred to our department in July 2019 for swelling of the right upper lip. He was diagnosed with clear cell carcinoma by biopsy. After tumor resection, upper lip reconstruction was performed with Estlander flap. The oral commissure on the affected side became drooping, thick and round. At 6 months postoperatively, secondary commissuroplasty was performed according to the Barsky technique. One year after surgery, the patient had a symmetrical lip and good lip closure.

Case 2
A 58-year-old male, He underwent lower lip reconstruction with an Estlander flap after excision of the right lower lip at another Hospital in April 2020. Histopathological diagnosis was adenoid cystic carcinoma. In May 2020, he was referred to our department for lip revision. The oral commissure on the affected side became small and round. At 6 months postoperatively, secondary commissuroplasty was performed according to the Barsky technique. Six months after surgery, the patient had a small volume of the lower lip near the oral commissure on the affected side, but the lip was symmetrical and the lip closure was generally good.

Discussion
The ingenuity of the Barsky method and the differences between Case 1 and Case 2 after secondary commissuroplasty are discussed.