Reconstruction of the lower lip.

INTRODUCTION: There are studies reporting the functional advantages of radiotherapy against surgical treatment. PURPOSE: Because of this we decided to substantiate the surgical treatment as a method of choice in the reconstruction of defects of lower lip after cancer resection. MATERIAL AND METHODS: The author has developed a modification of the method of Bernard for reconstruction of defects of the lower lip after cancer resection. RESULTS: A horizontal incision is made from the angle of the mouth to the cheek, and at the end of the incision a triangle of Burov is cut. After the resection of the tumour, from the lower edge of the defect (the transitional fold), a second incision is done with orientation to the submandibular area at the end of which a second triangle of Burov is cut. The incision takes into consideration the direction of skin folds for achieving better esthetic effect. This refined method was applied in 14 patients with lower lip carcinoma, 7 of them with unilateral flaps and 7- with bilateral flaps from 1994 to 1999. CONCLUSIONS: The functional and esthetic results of the modified method for lower lip reconstruction are better because they lead to better mobility, symmetry of the reconstructed lower lip and optimal wideness of the mouth and the sensitivity is preserved. A mathematical method for planning of the tissues, needed for the replacement of the defect after the excision of the tumour in healthy tissues are under development.

Lower lip cancer morbidity in three regions in South Bulgaria for a period of 15 years (1985-1999).

INTRODUCTION: In most of the countries lower lip cancer in men varies from 1.0 case per 100 000 (in England) to 8.9 cases per 100 000 (in Hungary). We have set as a PURPOSE: To follow the dynamics in lower lip cancer morbidity in three regions in South Bulgaria. MATERIALS AND METHODS: A cohort study of lower lip cancer is performed for a period of 15 years. RESULTS: In 1985 lower lip cancer morbidity for the three regions was 4.3 cases per 100 000 and in 1999 it was 3.49 cases per 100 000. Morbitdity retains a comparatively high level. In 1985 morbidity in men was 8.5 cases per 100 000 and in women it was 0.7 cases per 100 000. In 1999 the incidence of morbidity in men decreased to 4.9 cases per 100 000, while in women it increased to 2.1 cases per 100 000. The incidence of morbidity rises with age. The factor that most influences morbidity is smoking. A definite role plays also poor condition of the teeth (carious teeth, bad prostheses and crowns, dental calculus). CONCLUSION: The incidence of morbidity in lower lip cancer in men is 4 times as high as that in women.

Surgical treatment of squamous cell carcinoma of the lower lip.

INTRODUCTION: A controversy still exists regarding the preferable mode of treatment - surgical treatment or radiotherapy of 1st stage squamous cell carcinoma of the lower lip. That is why we have set as a PURPOSE: To compare the two methods of treatment and to propose a therapeutic approach. METHODS: A retrospective longitudinal study of patients with squamous cell carcinoma (SCC) of the lower lip from three regions in South Bulgaria (Plovdiv, Pazardjik and Smolian), who have been treated primarily with surgical operation (n=184) or by radiotherapy (n=592) was performed. RESULTS: Following up 184 patients who have undergone surgical treatment (vermilionectomy) as a primary therapeutic method for a period of 15 years, we have observed favourable results in 92.5% of the cases (n=170). We found local recurrences in 3.1% of the cases (n=6) and regional lymph-node metastases in 4.4% of the cases (n=8). Five-year overall survival rates was 81% and 10-year survival rates - 64%. The corresponding relapse-free five-year survival was 89% and ten-year survival - 82%. The results from the 592 patients treated with radiotherapy are: therapeutically cured - 90.5% of the cases (n=536), local recurrences - 4.3% of the cases (n=25) and regional lymph-node metastases (n=31.) CONCLUSIONS: Vermilionectomy is a suitable method for surgical treatment of 1st-stage SCC of the lower lip with a thickness of the tumour up to 3 mm and a size of the primary tumour up to 1.5 cm.

Tendencies in the oral cavity cancer morbidity in three regions of South Bulgaria for a period of 15 years (1985-1999).

INTRODUCTION: Oral cavity cancer constitutes 4% of all malignancies. In Bulgaria it is 2.21% of all malignancies. PURPOSE: In the present study we have set as an aim to investigate the tendencies of oral cavity cancer morbidity in three regions of South Bulgaria for a period of 15 years. METHODS: A retrospective epidemiological study of oral cavity cancer was performed. RESULTS: The calculated speed of growth is characterized with dynamic growth. Taking 1985 for a base, morbidity increases by 58.6% in 1999. Morbidity in men increased from 8.9 cases per 100 000 in 1985 to 10.12 cases per 100 000 in 1999; in women it increased from 1.4 cases per 100 000 in 1985 to 2.25 cases per 100 000 in 1999. We have found that morbidity in men over the age of 60 has increased more than 25 times and in women - more than 2 times. Mortality varies from 2.64 to 2.78 cases per 100 000. An important risk factor for oral cavity cancer development is poor oral hygiene. CONCLUSIONS: Oral cavity cancer morbidity increases from 3.6 to 8.08 cases per 100 000 in 1999. The risk is 6.9 times higher in men than in women. The risk factors are smoking, alcohol abuse and poor oral hygiene.