Versatility of the inferiorly based nasolabial flap for reconstruction in early oral cancer patients: Our experience in a tertiary cancer centre
Keywords:Loco-regional flaps Nasolabial flap, Oral cancer, Reconstruction
Background: The nasolabial flap is a simple, yet efficient method of soft tissue reconstruction with a very reliable blood supply which can be used to reconstruct soft tissue defects of various parts of the oral cavity. Aim of the study was to study the effectiveness of the inferiorly based nasolabial flaps for reconstruction in early oral cancer patients.
Methods: 28 patients with T1 or T2 malignant lesions of the oral cavity were studied retrospectively who underwent reconstructions using the inferiorly based nasolabial flap. Flap viability, wound problems, infections, function, scar and recurrence were noted post-operatively for all the patients included in the study. All patients were followed up for a minimum of 6 months after the surgery.
Results: The nasolabial flap was used to reconstruct defects of buccal mucosa, oral commissure, lower lip, lateral border of the tongue, hard palate and the floor of the mouth. The flap was viable in all patients with no recurrences. Cosmetic and functional outcomes were good. However few patients developed minor complications like post-operative trismus, severe wound contracture, ectropion and infection and wound dehiscence. Intra oral hair growth over the flap used were one of the main problems in the majority of male patients.
Conclusions: If proper attention is given to flap designing, operative technique and post-operative management, the NLF is a viable and versatile option for reconstruction of small to intermediate defects of the oral cavity created post ablation of early tumors of the oral cavity.
Shetty SK, Sarkar S. The versatility of nasolabial flaps in maxillofacial surgery. J Maxillofac Oral Surg. 2019;18(4):589-95.
Singh S, Singh RK, Pandey M. Nasolabial flap reconstruction in oral cancer. World J Surg Oncol. 2012;10:227.
Rahpeymaa A, Khajehahmadib S. The place of nasolabial flap in orofacial reconstruction: A review. Ann Med Surg. 2016;12:79-87.
Atkins JP, Keane WM, Fassett RL. Nasolabial flap reconstruction of the anterior floor of the mouth. Trans Acad Ophthalmol Otolaryngol. 1977;30(2):170172.
Ikeda C, Katakura A, Yamamoto N, Kamiyama I, Shibahara T, Onoda N, et al. Nasolabial flap reconstruction of floor of mouth. Bull Tokyo Dent Coll. 2007;48(4):187-92.
El-Marakby HH. The versatile naso-labial flaps in facial reconstruction. J Egypt Natl Canc Inst. 2005;17(4):245-50.
Pers M. Cheek flaps in partial rhinoplasty. Scand J Plast Reconstr Surg. 1967;1:37.
Varghese BT. Nasolabial flaps in oral reconstruction: an analysis of 224 cases. Brit J Plast Surg. 2001;54:499-503.
Gewirtz HS, Eilbe FR. Use of the nasolabial flap for reconstruction of the floor of the mouth. Am J Surg. 1978;36:508-11.
Morgan RF, Chambers RG, Jacques DA. Nasolabial flap in intra oral reconstruction: review of 55 cases. Am J Surg.1981;142:448-50.
Mutimer KL, Poole MD. A review of nasolabial flaps for intraoral defects. Br J Plast Surg 1987;40:472-7.
Hagan WE. Nasolabial musculocutaneous flap in reconstruction of oral defects. Laryngoscope. 1986;96(8):840-5.
Dupoirieusc L, Plane L, Gard C, Penneau M. Anatomical basis and results of the facial artery musculomucosal flap for oral reconstruction. British J Oral Maxillofacial Surg. 1999;37:25-8.
Campus G, Standoli N, Alfano C. Reconstruction of the lower lip with a full thickness nasolabial island flap. Scand J Plast Reconstr Surg Hand Surg. 1994;28:285-8.
Lazardis N, Zouloumis L, Venetis G, Karakasis D. The inferiorly and superiorly based nasolabial flap for the reconstruction of moderate-sized oronasal defects. J Oral Maxillofac Surg. 1998;56:1255-9.
Mutimer KL, Poole MD. A review of nasolabial flaps for intra-oral defects. Br J Plast Surg. 1987;40:47-9.
Joshi A, Rajendraprasad KS. Reconstruction of intraoral defects using facial artery musculomucosal flap. Br J Plast Surg. 2005;58:1061-6.
Georgiade NG, Mladick RA, Thorne FL. The nasolabial tunnel flap. Plast Reconstr Surg. 1969;43(5):463-6.
Roth J, Patete M, Goodwin WJ. Use of melolabial flap in intraoral reconstruction. Orolaryngol Head Neck Surg. 1996;114:12-7.
Hofstra EI, Hofer SO, Nauta JM, Roodenburg JL, Lichtendahl DH. Oral functional outcome after intraoral reconstruction with nasolabial flaps. Br J Plast Surg. 2004;57:150-5.
Zitelli JA. The nasolabial flap as a single-stage procedure. Arch Dermatol. 1990;126:1445-8.
Ducic Y, Burye M. Nasolabial flap reconstruction of oral cavity defects: a report of 18 cases. J Oral Maxillofac Surg. 2000;58:1104-8.