Objectives Reconstruction of head and neck cancer ablative defects is challenging. A modification of the nasolabial flap (islanded pedicled nasolabial flap [ipNLF]) is an easy and reliable option for reconstruction of small‐ to medium‐sized defects of the head and neck, especially in resource‐constrained and high‐volume centers. Study Design and Methods We present the retrospective analysis of 27 consecutive patients reconstructed with ipNLF at two high‐volume cancer centers, Homi Bhabha Cancer Hospital, Varanasi, India; and Army Hospital Research and Referral, New Delhi, India. The functional outcomes measured were duration of weaning of feeding and tracheotomy tubes and speech assessment (speech intelligible rating score [SIR]) postsurgery. Complications assessed were flap loss, orocutaneous fistula, donor site wound dehiscence, oral incompetence, and angle of mouth deviation. Results The most common ablative defect was of the oral cavity (22 patients), followed by the oropharynx (4 patients) and hypopharynx (1 patient). The mean operating time for flap harvesting and insetting was 57.7 minutes. The mean durations for postoperative feeding tube and tracheotomy removal were 10 and 5 days, respectively. Twenty‐four subjects had SIR scores of I or II. None of the subjects had flap loss, orocutaneous fistula, or donor site wound dehiscence. Twenty‐five subjects had no oral incompetence, and 26 subjects had no or minimal angle of mouth deviation. Conclusion This is the largest series of ipNLF to date and emphasizes the versatility, reliability, reproducibility and excellent functional and acceptable cosmetic outcomes of this flap for the reconstruction of judiciously chosen head and neck ablative defects. Level of Evidence 2C Laryngoscope, 130: 1967–1972, 2020

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The follow-up of patients who undergo partial glossectomy includes evaluation for residual, recurrent or new primary malignancy and the provision of ABSTRACT Background: The tongue is a frequent site for oral carcinoma. Quality of life in such patients is often compromised post treatment in terms of speech and swallowing functions. Although swallowing and speech are included in several health-related quality of life scales, postoperative rehabilitation that influences these domains is not very well studied. This study was conducted to assess the speech and swallowing impairment after partial glossectomy for the tongue cancer patients and role of speech therapy and swallowing rehabilitation exercises in effective postoperative rehabilitation. Methods: 50 patients of carcinoma of the tongue managed with partial glossectomy as the definitive treatment were included in the study. Postoperative rehabilitation was offered to all patients, however 10 defaulted. Improvement in speech intelligibility, articulation and swallowing at 15 days, 1 month, 3 months and 06 months after surgery were recorded. Results: All three parameters of speech intelligibility, articulation and swallowing which were analysed showed improvements during each follow-up visit. Results obtained for both groups, on comparison showed statistically significant earlier improvement in patients who were receiving rehabilitation therapy versus those who were not receiving any rehabilitation. Conclusions: Postop speech and swallowing rehabilitation can be an effective tool for improving quality of life. It is imperative to develop easy and simple modules for rehabilitation for patients of oral cancers that can be practiced during the postop follow up and at home with the assistance of family members to ensure uncompromised quality of life post treatment.

Reconstruction of neopharynx after total laryngectomy is a challenging task. Various locoregional flaps like pectoralis major myocutaneos/ latismus dorsi flaps and free flaps have their own limitations and advantages. To overcome this, we used facial artery-based cutaneous island flap (melo-labial flap) for reconstruction of the neopharynx following total laryngectomy (DK Gupta technique). This flap is thin, pliable, without any gravitational pull and without any risk of anastomosis failure and hence has advantage of both locoregional and free flaps and eliminates the limitations of both. It is simple, reproducible and reliable reconstructive option for neopharynx. We present a case report, review of literature and this novel technique for an excellent outcome and recommend to use it as the new workhorse of neopharyngeal reconstruction.

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