Clinical experience with the nasolabial fold as receptor site in microvascular reconstruction

Abstract

We report our experience using the vessels at the nasolabial fold as receptor site in free tissue transfer in head and neck reconstructions; a site that proved more convenient than the submandibulary site in selected cases. Six cases as well as the dissection technique of the nasolabial fold are reported. No complications occurred during or post surgery and in all cases the vessels were of adequate diameter for an end to end anastomosis. The advantages this site offers are discussed.

More than just the helix: A series of free flaps from the ear

“…Nasolabial vessel nomenclature is variable and terms such as “angular vessels,” “nasolabial vessels,” or “nasolabial facial vessels” all essentially refer to the same entity. Two anatomical and two clinical studies have corroborated our own experience that these vessels can be reliably dissected and are of suitable calibre for microsurgical anastomosis (Haffey, McBride, & Fritz, ; Oh et al, ; Smit, Ruhe, Acosta, Kooloos, & Hartman, ; Smit, Hartman, & Acosta, ). The latter two clinical studies also noted the more lateral and deep location of the facial nasolabial vein.…”

“…A vein graft to the facial artery in the neck was only required in one case. Several studies have reviewed the use of the nasolabial facial vessels as recipient vessels (Haffey, McBride, & Fritz, 2014;Oh et al, 2011;Shimizu et al, 2015;Smit, Ruhe, Acosta, Kooloos, & Hartman, 2009;Smit, Hartman, & Acosta, 2007). Nasolabial vessel nomenclature is variable and terms such as "angular vessels," "nasolabial vessels," or "nasolabial facial vessels" all essentially refer to the same entity.…”

The intraoral anastomosing technique in reconstructive surgery of the face – A consecutive case series of 70 patients

“…Submandibular or preauricular approaches or approaches via the nasolabial fold are used so that the skin incision is located in an inconspicuous region (Abul-Haasan et al, 1986;Pinar and Govsa, 2006;Hansen et al, 2007;Smit et al, 2007;Halvorson et al, 2009;Shimizu et al, 2009). Another technique that enables avoidance of visible scars is the intraoral recipient vessel approach (Gaggl et al, 2009).…”

“…(Yazar et al, 2005;Francis et al, 2009;Brands et al, 2010). If a special flap with the best suited tissue components having a short pedicle is selected, techniques of pedicle elongation have to be performed, or recipient vessels located closer to the defect must be selected and prepared (Abul-Haasan et al, 1986;Hansen et al, 2007;Smit et al, 2007;Vogt et al, 2007;Halvorson et al, 2009;Shimizu et al, 2009, Karle et al, 2013. The second main indication for microvascular tissue transfer in the face is coverage of non-extended defects with poor transplant bed conditions in which free nonvascularized tissue transfer has a high complication rate or has been previously unsuccessful.…”

The Nasolabial Fold as Potential Vascular Receptor Site: An Anatomic Study

“…[11][12][13] Inspired by a report by Pribaz et al, 14 we started using the facial vessels at the nasolabial fold as a microvascular receptor site in selected cases. 15 We used this location in maxilla reconstructions with a free microvascular bone transfer. To further investigate the potential of this site, we conducted this anatomic study.…”