Lip Cancer


September 7, 2012

Lip cancer is the second most common cancer of the head and neck. Lower lip cancer is nearly ten times as common as upper lip cancer. A common presentation for lip cancer is a nonhealing ulcer or scab on the lip. Risk factors of lip cancer include sun exposure, history of skin cancer, and use of tobacco products.

Patients who present to the ENT clinic with suspicious lesions will have a biopsy performed. There are a variety of tumor types that can exist, and the most common is a squamous cell cancer. Tumors of the lip are treated primary with surgery. The goals of surgery are:

  1. Removal of the tumor with clear margins
  2. Restoration of the function of lips, namely in its role in eating and articulation
  3. Aesthetic reconstruction

Our Otorhinolaryngologists are trained in Head and Neck Oncologic Surgery and participate in the multidisciplinary approach to head and neck cancers. In some cases, advanced lip cancers may proceed to involvement of lymph nodes in the neck. In these patients, surgery often involves removal of these lymph nodes. Radiation therapy and chemotherapy may be indicated for some advanced cancers of the lip.

One of the most important aspects of lip surgery is achieving a cosmetically pleasing result. Patients are very often concerned with the appearance of their lips following surgery. The importance of recreating an aesthetic harmony on the face cannot be overstated. Our Head and Neck Surgeons are trained and experienced in a wide variety of sophisticated techniques for lip reconstruction. Following removal of the cancer lesion, small defects can be repaired in an aesthetically pleasing manner by rearrangement of local tissue or attachment of remaining lip edges. Even large defects of the lips can be reconstructed using adjacent tissue in a manner which hides incision and leads to excellent functional and cosmetic results. In rare cases, distant tissue from the forearm or other areas of the body may be used for the reconstruction of very large areas of tissue loss in the Head and Neck.

This animation illustrates the surgical treatment of an advanced case of oral cancer arising from the lower lip and involving lymph nodes in the neck. The Head and Neck Oncologic surgery team begins with removal of the lip and oral cavity cancer, followed by neck dissections for removal of malignant lymph nodes in the neck. At the same time, a team of Facial Plastic and Reconstructive surgeons harvests an area of the forearm as donor tissue to reconstruct the lower lip and face. This donor tissue is called a free flap. The free flap is released from its native blood supply in the forearm and attached to arteries and veins in the neck. The forearm free flap will supply tissue to recreate the form and function of the oral cavity and lip.

This animation illustrates an advanced case of head and neck cancer as treated by members of the UT-Houston Otorhinolaryngology department. Our specialists in Head and Neck Oncologic Surgery as well as Facial Plastic and Reconstructive Surgery are trained and experienced in the management of complex tumors of the head and neck.


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