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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Accurate prognostication of the outcome of vocal fold immobility assumes great importance in the management. This study aimed to evaluate the prognostic efficacy of Laryngeal electromyography in cases of vocal fold immobility. A nonrandomized prospective study was carried out from Sep 2009 to Jun 2011. Patients were evaluated using Fiberoptic laryngoscopy and Laryngeal electromyography over a period of 24 weeks. 51 subjects participated in the study, comprised of 22 males and 29 females. All patients underwent detailed clinical examination including Fiberoptic laryngoscopy on the first visit and Laryngeal electromyography testing on the second visit. Subsequent neuromonitoring was carried out at 04, 12 and 24 weeks from date of initial recording. Outcome measures of vocal fold motion were dichotomized into persistent vocal fold immobility (unilateral or bilateral) or resolved vocal fold motion (normal). Approximately 24 weeks after onset of palsy, mobility of the paralyzed vocal cord was restored in 31 (60.78 %) of 51 cases, while 20 (39.22 %) remained immobile. Sensitivity of laryngeal electromyography was 92.53 % ; specificity 93.33 %, positive predictive value 98.77 % and negative predictive value 68.29 %. This study confirmed the utility of Laryngeal electromyography in predicting prognosis for recovery of vocal fold motion after laryngeal nerve injury. The results supported the hypothesis that Laryngeal electromyography data can be used effectively to determine a prognosis for recovery of vocal fold motion.

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