Nasolabial Flap For Reconstruction Research Articles

Comparative Evaluation of Postoperative Scarring with Nasolabial Flap Reconstruction Using Silicone Gel Versus Silicone Gel Sheet: Randomized Controlled Trial

Comparative Evaluation of Postoperative Scarring with Nasolabial Flap Reconstruction Using Silicone Gel Versus Silicone Gel Sheet: Randomized Controlled Trial

A Retrospective Study Comparing the Surgical Results of Platysma Myocutaneous Flap, Buccal Pad of Fat, and Nasolabial Flap for Reconstruction After Fibrotomy in Cases of Oral Submucous Fibrosis.

To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF). A retrospective study was conducted among patients diagnosed with grade III and IV OSMFin the Departmentof Oral and Maxillofacial Surgery at Sharad Pawar Dental Collegebetween January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre- and post-operatively. Student's unpaired t-test and chi-square test were employed for statistical analysis. Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group. All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.

The Islanded Nasolabial Flap: A Versatile and Reliable Flap for Reconstruction in Cancers of the Oral Cavity

On the Indian subcontinent, oral cancer represents a significant health burden. Local flaps offer a viable alternative to free flaps in specific reconstructive scenarios where free flaps may not be feasible. The islanded nasolabial flap, based on the facial artery, proves to be a robust and versatile option for single-stage reconstructions of oral cavity defects. In this study, we share our experience employing the islanded nasolabial flap at a high-volume cancer center in Central India for reconstructing buccal mucosa and tongue defects. This prospective observational study focused on approximately 76 patients diagnosed with squamous cell carcinoma of the oral cavity (specifically, the anterior 2/3rd of the tongue and buccal mucosa) at our cancer hospital between August 2021 and January 2023. Initially, 76 patients were included; however, four patients were subsequently excluded due to inadvertent facial vein injury during neck dissection caused by level IB node invasion. Consequently, 72 patients underwent islanded nasolabial flap reconstruction and were monitored for postoperative complications and functional outcomes. Our study's patients fell within the age range of 24 to 81 years, with the majority between 40 and 50 years old. Most of our patients had carcinoma affecting the anterior two-thirds of the tongue (61.11%), followed by carcinoma of the buccal mucosa (38.88%). Surgical site infection occurred in four patients (5.55%) at the donor site, and one patient (1.38%) experienced flap necrosis after tongue carcinoma surgery. However, the majority of our patients (93.05%) experienced no postoperative complications. Speech intelligibility was good for all patients (100%) with buccal mucosa cancer. A significant portion of patients (78.57%) could tolerate a normal diet, while 21.42% required a soft diet. Among patients with tongue carcinoma, 56.81% had good speech intelligibility, and 43.18% had acceptable speech intelligibility. Regarding swallowing capacity assessment, 65.90% of patients tolerated a normal diet, and 34.09% could manage a soft diet. None of our patients had poor speech intelligibility, and none depended on a liquid diet or tube feeding. This study underscores the versatility of the islanded nasolabial flap in oral cancer resection reconstruction. The islanded nasolabial flap proves to be a straightforward, effective, and reliable technique with a low incidence of complications and exceptional functional outcomes, establishing it as a valuable reconstructive option for small-to-medium-sized oral defects. This is particularly noteworthy for high-volume centers and regions with limited resources.

Versatility of use of nasolabial flap in reconstruction of maxillofacial defects: Our experience

Versatility of use of nasolabial flap in reconstruction of maxillofacial defects: Our experience

Partial Maxillectomy Using a Novel Nasolabial Surgical Approach with Simultaneous Nasolabial Flap Reconstruction of the Maxillary Defect: Our Surgical Experience of 10 Cases

Partial Maxillectomy Using a Novel Nasolabial Surgical Approach with Simultaneous Nasolabial Flap Reconstruction of the Maxillary Defect: Our Surgical Experience of 10 Cases

Utility of Single-Stage Nasolabial Flap Reconstruction for Oral Cavity Defects Following Surgery for Oral Cancers and Premalignant Lesions: A Clinical Audit.

An inferiorly based nasolabial flap (NLF) is a versatile flap for various oral cavity defects. However, it generally necessitates a second stage procedure to release the base at 3weeks following the initial surgery. Reconstruction for oral cavity defects can be done with the inferiorly based nasolabial flap as a single-stage procedure. In this retrospective clinical audit, we analyzed patients who underwent an inferiorly based NLF reconstruction for oral cavity defect from January 2016 to September 2021. We analyzed the various defects for which this flap was used along with the associated complications and the safety of performing this flap in terms of its flap-related complications and the histopathological features such as margins. Forty-four patients underwent this inferiorly based single-stage NLF. The median age of the patients in the cohort was 56years, with the majority being men (n = 38, 86.4%). Buccal mucosa and lip were the most common sites of the primary. Twenty-nine patients were per primam and 15 were recurrent cancers. Most had T1 (n = 14, 31.8%) and T2 (n = 19, 43.2%) cancers. The median closest margin was 6mm and the base was 7mm. There were no flap losses; however, 6 patients had minor wound breakdown for which secondary suturing was needed. Single-stage NLF is a safe flap that could be considered in select patients for appropriate oral cavity defects.

The islanded nasolabial flap for tongue reconstruction – Experience in our institute

Background: Oral cancer ranks in the top three of all cancers in India, which accounts for over thirty per cent of all cancers reported in the country. Tongue cancers make a significant percentage among the oral cancer burden. Unfortunately, patients rarely present to the surgeon with a tongue cancer lesion small enough for a primary closure. Hence we frequently need some type of flap for reconstruction of the tongue defect following ablative surgery. In defects that are not small enough for a primary closure as well as not big enough for a more bulky flap like the PMMC or the free ALT flap, the islanded nasolabial flap is of great use to the surgeon for tongue reconstruction and should be part of the reconstructive armamentarium of every oral cancer surgeon. Aims and Objectives: To assess the difference in post-operative speech results between patients having flap reconstruction versus patients having primary closure, and to assess the complications of islanded nasolabial flap reconstruction. Materials and Methods: Retrospective study of 6 months with 11 patients having islanded nasolabial flap reconstruction and 18 patients having primary reconstruction. Results: Post-operative speech results of patients with flap reconstruction were as good as those having primary closure. Conclusions: Islanded nasolabial flap may be a good option for reconstruction of carefully selected tongue defects.

Basal cell carcinoma of the ala of nose: a case report

<p class="abstract">Basal cell carcinoma (BCC) of nose is common with potential of local recurrence and high risk features. We are reporting a case of BCC on the right ala of nose in an elderly female patient hailing from rural background, who came to our OPD for cosmetic outcome. She was treated with wide local excision with nasolabial flap reconstruction. The tissue when sent for HPE came up with BCC with margin involvement. Hence she was sent to chemoradiotherapy after 3 weeks of surgery, after complete wound healing.</p><p class="abstract"> </p>

Superior nasolabial flap in reconstruction of the tongue: case report

<p class="abstract">Hemiglossectomy with functional rehabilitation using a rotational superior nasolabial flap as a single stage procedure and its outcome has been described. Nasolabial sulcus and nasofacial was the donor site for the nasolabial flap. This hairless area except for the lower cheek in males, is an important consideration in oral cavity reconstruction. The flap constituted by skin, subcutaneous tissue and the underlying musculature has a subdermal plexus is supplied by feeder vessels from the branches of the facial artery and provides the blood supply to the nasolabial muscle and skin. Usually, the choice of pedicle is based on the site of the defect and any need for rotation or advancement of tissue to the site of the defect. In our patient the superior nasolabial flap based on alar and lateral nasal artery was utilized.</p><p class="abstract"> </p>

Vascularised periosteal free flap reconstruction for medication-related osteonecrosis of the jaw: a case series

Introduction: The standard of care for medication-related osteonecrosis of the jaw (MRONJ) involves anti-biotics and local debridement to promote tissue healing over exposed bone. We compare outcomes for patients with advanced MRONJ managed with vascularised periosteal radial forearm free flap (RFFF) ver-sus local nasolabial flap and conservative dental measures. Methods: A retrospective case series of patients presenting to the Alfred Hospital for evaluation and man-agement of stage II or above MRONJ between 1 January 2014 and 30 June 2018. The hospital database was searched And a medical record review performed. Results of pre- and post-treatment imaging were ana-lysed bya single senior radiologist blinded to treatment modality . Asymptomatic wound closure, radio-logical evidence of disease cessation and patient satisfaction at six months post-treatment according to treatment type were assessed. Results: Of the ten patients included in the study, four received dental measures, three received local na-solabial flap and three received RFFF flap. All flap reconstruction (6/6) showed asymptomatic wound clo-sure and patient satisfaction at six months follow-up compared to patients managed with dental measures (1/4). All RFFF patients (3/3) showed increased bone deposition radiologically at six months compared to the dental group who showed a mixed (3/4) picture or worsened (1/4) picture. Nasolabial flap patients showed a mixed (2/3) or improved radiological picture (1/3). Conclusion: MRONJ is a relapsing disease. Preliminary evidence suggests that radical debridement with local nasolabial flap or RFFF reconstruction for advanced MRONJ is more effective at halting the disease and alleviating morbidity than conservative dental measures alone.

Basal Cell Carcinoma at the Tip of the Nose – A Case Report

Skin cancers contribute very less to the total number of carcinomas. Particularly when on the face or exposed parts affect cosmetically more than functionally. Basal Cell Carcinoma over face is a locally destructive malignancy of the skin which rarely metastasizes. Basal cell carcinomas are the most common type of cancer in Europe, Australia, and the USA. A case of basal cell carcinoma is reported here in an adult female living in a rural area, who came for cosmetic purpose in the Department of Dermatology & Venereology, Community Based Medical College, Bangladesh (CBMC,B) Hospital, Mymensingh, Bangladesh and was transferred to the Department of Otolaryngology & Neck-Head Surgery of the same institution for better management. She was treated with best of the modalities available, i.e., wide local excision with local Nasolabial flap reconstruction with follow up.
 CBMJ 2021 January: vol. 10 no. 02 P: 115-117

An Inclusion Epidermoid Cyst, a Rare Complication of Versatile Naso-Labial Flap

We are reporting a case of 47 years old gentleman who was diagnosed with left lower alveolus carcinoma and later on he presented with epidermal inclusion cyst post oncological resection with nasolabial flap reconstruction. Compared to microsurgical free flaps, nasolabial flaps are simple, easy to learn, one staged procedure and provides good cosmetic results. It can be used bilaterally for coverage of both, intra-oral and extra-oral defects. It is highly vascular flap with blood supply from the facial, transverse facial, angular, infraorbital, infratrochlear artery and the free anastomosis between the terminal branches overlying the nasolabial skin. The important thing in harvesting this flap is to avoid implantation of epidermal tissue like hair follicles, sebaceous glands and sweat glands into the deep tissues. Inadequate de-epitheliaslisation results in formation of inclusion cyst during transposition of flap through trans-buccal tunnel into the oral cavity. Formation of inclusion epidermoid cyst is a rarely encountered phenomenon in head and neck cancers.

P-159 Outcomes of nasolabial flap reconstruction for oral defects in surgical treatment of oral cancer

P-159 Outcomes of nasolabial flap reconstruction for oral defects in surgical treatment of oral cancer

Oral verrucous carcinoma –A rare variant of ca oral cavity

Introduction: Oral verrucous carcinoma is an uncommon variant of oral squamous cell carcinoma. Demographics, clinical presentation and surgical outcomes are believed to be different from oral squamous cell carcinoma. Methodology: A single case report of verrucous carcinoma managed wide local excision of tumour with Level 1 and 2 lymph node dissection followed by Nasolabial flap reconstruction. Discussion: Verrucous carcinoma is any exophytic growth of well differentiated squamous cell carcinoma which generally presents as white warty lesion. They are slow growing with very low metastatic potential and good prognosis. Thus neck dissection and radiotherapy and chemotherapy can be avoided or limited to supraomohyoid neck dissection with close follow up.

Nasolabial flap reconstruction of an oral defect after buccal tumor resection

Nasolabial flap reconstruction of an oral defect after buccal tumor resection

Clinical Profile and Quality of Life Assessment of Oral Cancer Patients Following Nasolabial Flap Reconstruction Surgery.

To evaluate the quality of life (QOL) of oral cancer patients who had undergone surgical reconstruction with nasolabial flap. A cross-sectional study was conducted over a period of 1year at a tertiary care hospital and 128 subjects were included. The subjective assessment of quality of life using The University of Washington QOL Questionnaire including physical, socio-emotional, composite and overall QOL, Objective assessment of functional mouth opening and Nasolabial crease scar assessment using Vancouver scar scale was done. Majority of the subjects, 98.4% were male. Maximum cases were involving the lower gingivobuccal complex and retromolar trigone followed by buccal mucosa. Majority of the tumors were T2, 53.1% followed by T1, 18.8%. Statistically significant (p < 0.05) difference was found in relation to age, tumor size (T1, T2, T3), absence of adjuvant radiation therapy, presence or absence of neck dissection, tumor site; buccal mucosa and lower gingivobuccal complex plus retromolar trigone and intact bone status in physical functional, social-emotional subscores, composite score and overall QOL assessment. Improved mouth opening postoperatively was statistically significant (p < 0.05) in T1 and T2 lesions of buccal mucosa and lower gingivobuccal complex plus retromolar trigone who did not receive radiation and with intact bone status. Majority of the cases, 36.7% had a nasolabial crease scar score 2. Nasolabial flap is a viable option in the reconstruction of small and medium sized oral defects with good quality of life (QOL) outcome and objective outcome as depicted by significantly improved mouth opening. The aesthetic outcome of nasolabial crease scar is good in our study.

Pedicled Islanded Nasolabial Flap Tunneled Under Mandible for Tongue Reconstruction

Nasolabial flap is reliable flap in the reconstruction of oral defects over a period of time. Still there is scanty literature available of using this flap for reconstruction of isolated defects of tongue. We carried out this study in our patients to assess the role of pedicled nasolabial flap in reconstruction of isolated tongue defects. In total, 11 patients with T1 and T2 tongue cancer were selected for the study. The functional improvement in the form of speech and swallowing was evaluated postoperatively. The flap was successfully taken in all patients except for marginal or tip loss. This is a locally available flap with minimal operating time and does not require microvascular skills. The results of speech and swallowing after reconstruction were comparable. Nasolabial flap is an excellent locally available flap for the reconstruction of the anterior two-thirds of the tongue and with very minor, if any postoperative cosmetic defect.

Outcome of Nasolabial Flap in the Reconstruction of Head and Neck Defects

Nasolabial flaps have been recognized as versatile flaps for a variety of defects in the face, nose, lip and the oral cavity and intraoral defects created after the excision of benign and malignant tumours. Nasolabial flaps have been utilized for covering small-to-medium size defects and usually require a second-stage procedure to divide the flap. To study the outcome of nasolabial flap in the reconstruction of head and neck defects. A prospective analysis of 25 cases was done. Of this, 24 cases were oral cancers, and one case was post-traumatic left ala loss. Oral cancers from stage I to IVa were treated with primary wide local excision, nasolabial flap reconstruction and neck dissection. Of this, 3 cases underwent bilateral nasolabial flap reconstruction. Flap release was done as a second-stage procedure after 3weeks. Good cosmetic and functional results were obtained in almost all cases. Flap tip necrosis was noted in 2 cases, ectropion in 1 case, orocutaneous fistula in 1 case and disease recurrence in 2 cases. Pedicled nasolabial flap is a reliable flap for the reconstruction of small- and medium-sized defects in the oral cavity after excision of primary tumours and results in good overall cosmetic and functional outcome.

Metastatic rectal adenocarcinoma in the maxillary bone: A case report

Introduction: Colorectal cancer patients presenting with isolated bone metastases are exceedingly rare. Case Report: A 72-year-old male patient appeared with a painless gross swelling in the anterior maxillary gingiva, nearly a year after anterior rectal resection for cancer. The patient was submitted to lesion excision and nasolabial flap reconstruction. Histology revealed an intestinal type adenocarcinoma. The patient underwent radiotherapy. The disease spread and our patient lost his battle with cancer. Conclusion: Rectal tumor metastasis to maxillary bone is exceedingly rare and a high index of suspicion must be maintained in order to timely diagnose and treat it. Intraoral reconstruction with a nasolabial flap is a simple and fast procedure with good cosmetic and functional results.

Clinical efficacy of facial artery perforation nasolabial flap in reconstruction of nasal defect

Objective To evaluate the effects of nasolabial flap with facial artery and its branches perforator for reconstruction of nasal defect. Methods Between March 2013 and April 2017, 21 patients underwent operations for the reconstruction of nasal defect, caused by trauma, surface tumors, moles and infection. The size of the defect was 1.5 cm × 2.0 cm to 3.0 cm × 3.0 cm. Designed various nasolabial perforator flap was pedicled with the facial artery. The pulsed blood flow detector determined the location of the facial artery and its perforation position, which was the rotation point, and the rotation of the nasolabial fold flap covered the nasal defect area to repair. Results 21 flaps survived. Surface artery perforation nasolabial fold flap was good blood supply, of which 1 case of flap was congested and recovered after treatment. After 1 month to 3 years follow-up on 21 cases, 20 cases showed good results and 1 case had generally accepted. The color, shape and function of the flap were significant, similar to the normal skin. Conclusions A small area defect in the nose is preferred by using facial arterial perforation nasolabial fold flap repair, which does not need secondary repair, and is worthy of clinical application. Key words: Nose; Nasolabial fold; Perforators flap; Reconstructive surgical procedures; Defects