A modified full‐thickness labial/buccal rotational flap reconstruction technique following bilateral rostral maxillectomy and nasal planectomy for resection of maxillary tumors: Technique and results in two dogs

Abstract

ObjectiveTo describe a naso‐facial reconstruction technique following bilateral rostral maxillectomy and its functional and cosmetic outcomes.AnimalsTwo dogs.Study designClinical case series.MethodsTwo dogs were presented with a right rostral maxillary mass. Preoperative biopsy and staging revealed a biologically high‐grade and histologically low‐grade fibrosarcoma (Hi‐Lo FSA). A combined nasal planectomy and radical bilateral rostral maxillectomy was performed sparing the labial/buccal mucocutaneous flaps bilaterally. Surgery resulted in asymmetry of the width of the flaps; the narrower flap was rotated medially to reconstruct the lip and create an oral vestibule. The wider flap was rotated medially to cover the remaining dorsolateral opening of the nasal conchae. The flaps overlapped in a parallel manner, discretely concealing the nasal passages, and separating them from the oral cavity. Hemorrhage occurred in both dogs, with one dog requiring a blood transfusion postoperatively.ResultsOral Hi‐Lo FSA with tumor‐free margins was confirmed in both dogs. Both dogs recovered uneventfully within 4 weeks. Owners reported being very satisfied with the functional (return to normal exercise/activities and uncompromised respiration) and cosmetic outcomes. Based on the owners' telephone follow up, no tumor recurrence was noted at 15 (Dog 1) and 6 (Dog 2) months postoperatively.ConclusionThe full‐thickness bilateral labial/buccal rotational flaps were used successfully to reconstruct the rostral maxilla, external nose and facial defects involving the nasal cavity. The technique resulted in acceptable functional and cosmetic outcomes and can be considered for naso‐facial reconstruction in selected cases.

A Rotation Alar Fold Flap for Cosmetic Nasal Plane Reconstruction: Description of the Technique and Outcome in Three Dogs

“…However, nasal planum reconstruction remains surgically challenging due to constraints of normal anatomy, impacting options for wide local excision [7], and due to the lack of free local tissue to reconstruct the original appearance of the nose [8]. In veterinary medicine several surgical nasal reconstructive techniques have been described: purse-string reconstruction with second intention healing [4,9,10], musculofascial island labial flap [11], direct mucocutaneous apposition [12], bilateral labial mucocutaneous rotation-advancement flaps [5,13], modified nasal rotational flap [8], lipto-nose flap [14,15], and recently, modified full-thickness labial/buccal rotational flap [16]. The choice of the most appropriate technique is based on the type, location, size, and extent of the tissue excision.…”