The skin between the defect and the flap is excised to allow the flap to reach the defect. Nasolabial flaps in the treatment of mronj surgical case. Nasolabial flap alternative uses for a classic but. A retrospective analysis of 26 cases of oral cancer treated with primary excision and nasolabial flap reconstruction was carried out. Fiftyseven years later, esser 1921 described the use of the inferiorly based nasolabial flap to close palatal fistulae esser, 1921. Nasolabial flaps in the treatment of mronj a b s t r a c t.
We present a case of lip reconstruction following a total resection of the upper lip. Extended nasolabial flap a versatile reconstruction. Superiorly based nasolabial flap for nose reconstruction. This technique is well suited to repair defects of the floor of the mouth up. Defect in the anterior face, nose and upper lip, floor of the mouth oaf 48. Sliding flap transferring a flap to its new position using a sliding similar to an advancement flap. Reconstruction of oral mucosal defects using the nasolabial. A retrospective analysis of 26 cases of oral cancer treated with. Nasolabial flap is an old flap for reconstructive purposes. This flap is often classified as an axial flap because there is a named artery which runs deep to the flap angular artery. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal.
Ohtsuka editorial comment in treating defects of the face, the possibility of primary closure and even the use of split or fullthickness skin. Pdf the reverse nasolabial flap with a cartilage graft for the. Nasolabial flap for tongue reconstruction 321 p j m h s vol. Nasolabial perforator flap for onestage reconstruction of nasal.
The reverse or turnover nasolabial flap is a variant of the. This is more so when the resection is total and a complete lip has to be constructed. Nasolabial flap reconstruction in oral cancer world journal. Its main indications are deep and extensive defects of the nasal ala. One stage reconstruction of the floor of the mouth with a. N2 by using stereographic angiograms, the three dimensional structures of skin perforators originating from the facial, lateral nasal, dorsal nasal, angular, infraorbital, and transverse facial arteries were observed. Nasolabial flap for basal cell carcinoma of the nose. This prospective study evaluates the efficacy of nasolabial flap in the reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis in terms of functional and esthetic outcomes. May 20, 2019 the history of nasal reconstruction mirrors the history of plastic surgery, beginning with what commonly is believed to be the earliest plastic surgery procedure recordednasal reconstruction by sushruta in india during 600700 bc, as reported by rogers. Jul 11, 2017 nasolabial folds are the deep wrinkles or lines that form from the bottom of the nose to the corners of the mouth.
In our experience nasolabial flap is a very reliable flap for the alar defects after tumor resection. Nasolabial skin flaps to the cheek plastic surgery key. Postoperative physiotherapy was given to all the patients, with 1 year follow up. An analysis of 224 cases the nasolabial flap is a simple option for the reconstruction of selected oral defects. The reverse or turnover nasolabial flap is a variant of the conven tional nasolabial flap. Reconstruction was performed by using the reverse nasolabial flap and a. All of them had initial interincisal opening of less than 22 mm.
Disadvantages of the nasolabial flap are that there is a limited amount of tissue available. Reconstruction of the nasal defects by nasolabial flaps 66 the nasolabial flap can be taken from the area of redundancy that extends from the inner canthus to the inferior margin of the mandible, especially in old patients, this area is considered the good donor area to cover nasal defects because of its proximity, the color. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. Redundant skin extends from the medial canthus of the eye to the inferior margin of the mandible. The nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. Inferiorly based nasolabial flap is a reliable, economical option for the management of oral submucous fibrosis borle et al, 2009. This prospective study evaluates the efficacy of nasolabial. Request pdf nasolabial flaps in oral reconstruction.
It provides thin, local tissue for coverage of small defects. This patient is an 89yearold gentleman with a large squamous cell carcinoma of the right lateral nasal area. Medicationrelated osteonecrosis of the jaw mronj occurs as a side effect of several drug classes, including antiresorptives and antiangiogenics. Patients and methods fortyseven consecutive patients 46 men and 1 woman aged between 18 and 44 years of age, were. Efficacy of nasolabial flap in reconstruction of fibrotomy. The cases illustrated demonstrate a good alternative when the simpler techniques will not suffice. Melolabial flap a flap from the medial cheek is used as a transposition often erroneously referred to as flap to repair a defect on the side of the nose. Cheek skin has a similar color and texture to nasal skin, and the donor site scar can be hidden in a naturally occurring cheek fold. Reconstruction of the nasal defects by nasolabial flaps 66 the nasolabial flap can be taken from the area of redundancy that extends from the inner canthus to the inferior margin of the mandible. Pdf the nasolabial flap is an excellent choice for use in reconstruction of the nasal alar subunit due to its inherent properties that match skin. If it is superiorly based for resurfacing of the nose, it should be based on the angular vessels and swung like a pendulum, rather than as a rotation flap, to avoid an excessive dogear. The study includes the indications of use of the flap, flap design, technique, and the complications rate. Versatility and reliability of islanded pedicled nasolabial.
The history of nasal reconstruction mirrors the history of plastic surgery, beginning with what commonly is believed to be the earliest plastic surgery procedure recordednasal reconstruction. Pdf expanded uses for the nasolabial flap researchgate. The nasolabial flap is one of the most ancient techniques used in orofacial surgery. The reverse nasolabial flap with a cartilage graft for the. Arterial anatomy of the nasolabial flap keio university. Design and preparation of reversed nasolabial flap after complete resection, a reversed nasolabial flap pedicled with the superior labial vessels was designed and centered on the nasolabial area proximal to. This basal cell carcinoma of the nose was excised and repaired with a nasolabial rotation skin flap. Picture of nasolabial flap for basal cell carcinoma of nose. Reconstruction of alarperialar defects with a combined subcutaneous and cutaneous pedicled rotationadvancement nasolabial flap.
Nasolabial flap, ala reconstruction, skin tumors structive surgeon 4,5,6. Aug 08, 2019 all of them had initial interincisal opening of less than 22 mm. Nasolabial flap definition of nasolabial flap by medical. In this procedure, skin is transplanted from the cheek to the nose in two outpatient procedures. A modification of the nasolabial flap islanded pedicled nasolabial flap ipnlf is an easy and reliable option fo. All the surgeries were performed under 4x loupe magnification. The bilateral inferiorly based nasolabial flap has utility in the reconstruction of the anterior defects of the floor of the mouth. Objectives reconstruction of head and neck cancer ablative defects is challenging. The shape of the flap was generally consistent with aesthetic subunit of the defect.
Oct 30, 2012 the nasolabial flap can also be used as an interpolation flap in either a single or a staged technique. Ohtsuka editorial comment in treating defects of the face, the possibility of primary closure and even the use of split or fullthickness skin grafts should be considered first. Reconstruction of the nasal defects by nasolabial flaps. The nasolabial interpolation flap is an essential flap in nasal reconstruction. The flap consist of skin subcutaneous tissue and underlying musculature the flap can be used unilaterally or bilaterally for reconstruction. This flap is often classified as an axial flap because there is a named artery. Thirtyeight flaps were used for partial or complete tip. Oct 04, 2014 superiorly based nasolabial flap closure of the oro antral fistulae. For reconstruction of the buccal mucosa, lower alveolus, tongue, or floor of the mouth where. The nasolabial flap is an excellent choice for use in reconstruction of the nasal alar subunit due to its inherent properties that match skin tone and the convexity of the nose.
She is shown preop left, after the nasolabial flap middle, and 3 months after the resection of the nasolabial flap right. We propose a new protocol for the management of oral submucous. Case reports in surgery hindawi publishing corporation. Besides providing a good colour match, the flap is easy to dissect and inset. Design and preparation of reversed nasolabial flap after complete resection, a reversed nasolabial flap pedicled with the superior labial vessels was designed and centered on the nasolabial area proximal to the paranasal and infraorbital defect figure 1. Feb 19, 2020 mediumsized defects of the nose can be closed by rotation flaps with skin borrowed from the glabella, upper nasal dorsum, or nasolabial sulci. Mediumsized defects of the nose can be closed by rotation flaps with skin borrowed from the glabella, upper nasal dorsum, or nasolabial sulci. Case report reversed vascular nasolabial flap pedicled with. Disadvantages of the nasolabial flap are that there is a limited amount of tissue available, the reconstruction may lead to asymmetry, and a pincushioning effect of the cheek can occur when the flap is used for intraoral reconstruction. The authors report two cases of patients with skin cancer treated surgically with variations of the classic nasolabial flap by transposition bilateral and folded that highlight the broad applicability of this technique. The patients were treated with bilateral release of fibrous bands, coronoidotomy, and grafting with extended nasolabial flap. The authors report two cases of patients with skin cancer treated surgically with variations of the classic nasolabial flap. Journal of oral and maxillofacial surgery, medicine, and. The sliding nasolabial flap, frequently used for defects at the labial border of the nose, is especially advantageous for persons who are elderly and typically have excessive skin in this area.
Jan 12, 2015 the nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. Dec 08, 2009 this patient is an 89yearold gentleman with a large squamous cell carcinoma of the right lateral nasal area. In 22 cases, the excision was combined with neck dissection and facial artery ligation. The nasolabial flap is a hardy flap that finds its use in the everyday reconstruction of various defects in the head and neck.
Considerable confusion exists regarding the nature of the blood supply of the inferiorly based nasolabial flap. While theyre extremely common, their severity can vary. Nasolabial flap is a versatile flap well suited for single stage reconstruction. The nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors. It is commonly used as a superiorly based flap to reconstruct nasal defects and oral defects located in the upper sulcus or palate. A subcutaneous pedicled inferiorly based nasolabial flap can provide a one stage repair. Nasolabial and cheek skin flaps plastic surgery key. Nasolabial flap for oral cavity reconstruction vula university of. Use of nasolabial flap in the management of oral submucous. Reconstruction of alarperialar defects with a combined. Oct 30, 2012 the nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors. Full thickness skin grafts give a better cosmetic result than a nasal labial flap but should only be used for small superficial defects.
To evaluate the usefulness of the nasolabial fold interpolation flap for alar reconstruction after mohs micrographic surgeryespecially in an outpatient setting and. Technique of nasolabial flap insetting using a tunnel. Pedicled nasolabial flap is a reliable flap for the reconstruction of small and mediumsized defects in the oral cavity after excision of primary tumours and results in good overall cosmetic and. Nasolabial flaps were performed in 40 patients, for reconstruction of. In 8 of these patients, the facial artery was carefully dissected and preserved while doing. Its blood supply can be based on muscular perforators so that the skin base can be narrowed or the flap converted to an island. Pdf a 65yearold woman with a deeply infiltrating basal cell carcinoma in the right ala underwent fullthickness excision of most of the ala.
Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. Melolabial flap a flap from the medial cheek is used as a transposition often erroneously. Nasolabial flap for tongue reconstruction pjmhs online. Use of nasolabial flap in intra and extraoral reconstruction. The place of nasolabial flap in orofacial reconstruction. Cameron editorial comment the versatility and usefulness of the nasolabial flap are well known.