Reconstruction of oral mucosal defects using the nasolabial flap: clinical experience with 22 patients

Abstract

BackgroundVarious surgical options are available for reconstruction of intraoral soft tissue defects. For smaller defects of the oral mucosa in different anatomic locations of the oral cavity the nasolabial flap is a very useful and simple alternative to other pedicled flaps and free flaps.MethodsThe results of reconstruction of oral mucosal defects or facial skin defects using 29 nasolabial flaps in 22 patients were reviewed retrospectively.ResultsThe patient group consisted of 16 patients (70%) with squamous cell carcinoma of the oral cavity, 2 patients (10%) with cystic lesions of the maxilla, 3 patients (15%) with osteonecrosis of the jaw, and 1 patient with an oral metastasis of a lung carcinoma. Healing was uneventful in 93%, partial or complete flap loss was observed in 7%.ConclusionsThe nasolabial flap is a valuable alternative for reconstruction of smaller defects of the oral cavity in particular in older and medically compromised patients.

One stage reconstruction of the floor of the mouth with a subcutaneous pedicled nasolabial flap

“…The flap success rate was 100% with no total or partial flap loss in spite of re exploration of one patient for the evacuation of a reactionary haemorrhage where the flap was resutured again without any effect on the vascularity. Such results compare favourably with the reported studies [3,22,24,25] where the incidence of partial flap loss was ranged from 5% to 6.5%.…”

“…The flap represents a functional and aesthetically satisfactory alternative to reconstruction by micro surgical flaps in cases with defects of up to 5 · 5 cm in size, especially in older, medically compromised patients who are therefore of poorer surgical risk [19,3]. It can also improve mastication and speech when used in conjunction with micro vascular free tissue transfer for the reconstruction of large combined defects of the tongue and floor of the mouth.…”

“…A subcutaneous pedicled flap can be raised inferiorly in the reconstruction of moderate sized defects in the face and the floor of the mouth [12]. The direction of pull upward and laterally has an effect in holding the tongue up and preventing it from sinking down into the mouth during healing [3]. De epithelialisation of the proximal segment of the flap is proposed for a one stage repair of a variety of significant intraoral defects.…”

“…[2][3][4][5]. Three outcome measures (speech, chewing and deglutition) were used for the assessment of function and subjectively evaluated.…”

“…Various surgical options are available for the reconstruction of intraoral soft tissue defects. For smaller defects of the oral mucosa in different anatomic locations of the oral cavity the nasolabial flap is a very useful and simple alternative to other pedicled flaps and free flaps [3]. Nasolabial flaps are very suitable for small sized oral defects as it provides a safe, simple and an effective method of reconstruction of such defects [2].…”