Orbicularis oris myomucosal island flap transfer to the nose

Abstract

We developed the orbicularis oris myomucosal island flap (OOMMIF) to reconstruct the nasal lining in one stage. The OOMMIF blood supply derives from the intramuscular vascular network which communicates with the submucosal vascular plexus via the vascular network formed by the deep ascending branches of the superior labial artery. An oral mucosal flap of approximately 2 x 3cm can be harvested from the upper lip pedicled solely on the orbicularis oris muscle. We transferred this flap to a nasal lining defect located in the ala in four patients, the nasal floor in two patients, and the columella in two patients. The flap donor site was closed primarily. All flaps took completely with satisfactory results. Minor complications included slight asymmetry of the vermilion height due to donor site contracture in one patient and flap drooping in two patients corrected by secondary debulking. Upper lip functional loss was not observed, although upper lip hypoaesthesia occurred in one patient, which disappeared within 6 months. An OOMMIF can be easily elevated with minimal donor site morbidity. Thus, the OOMMIF is a good candidate for one-stage reconstruction of small nasal lining defects.