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Reconstruction of the anterior floor of the mouth using a labial mucosal flap.

"Definitive extirpative surgery alone is no longer an acceptable approach to the management of intra-oral carcinoma. With the resultant functional impairment of the oral cavity, it is incumbent upon the surgeon to accept the responsibility for performing a well-conceived plan of surgical reconstruction." Two cases are presented in this paper, both of which had T2 squamous cell carcinoma lesions of the anterior floor of the mouth. Each case was amendable to wide excision with marginal mandibulectomy and neck dissection. Closure in the first case was accomplished in the conventional manner by suturing the tongue anteriorly to the lip, necessitating a secondary skin graft vestibuloplasty to restore function and esthetics. Had postoperative radiotherapy been required, such a procedure may not have been possible or would have been difficult. Most surgeons agree that the best time to correct any deformity is at the first operation. In the second case, this was accomplished by the use of a simple mucosal pedicle flap supported by a surgical stent. Serious complications may have been avoided if a secondary reconstructive procedure had to be performed after radiotherapy.