This patient is an 89yearold gentleman with a large squamous cell carcinoma of the right lateral nasal area. Thirtyeight flaps were used for partial or complete tip. In 22 cases, the excision was combined with neck dissection and facial artery ligation. Nasolabial flap for basal cell carcinoma of the nose.
Oct 30, 2012 the nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors. This flap is often classified as an axial flap because there is a named artery. Dec 08, 2009 this patient is an 89yearold gentleman with a large squamous cell carcinoma of the right lateral nasal area. All of them had initial interincisal opening of less than 22 mm. A retrospective analysis of 26 cases of oral cancer treated with primary excision and nasolabial flap reconstruction was carried out. An analysis of 224 cases the nasolabial flap is a simple option for the reconstruction of selected oral defects. It provides thin, local tissue for coverage of small defects. This flap is often classified as an axial flap because there is a named artery which runs deep to the flap angular artery. To evaluate the usefulness of the nasolabial fold interpolation flap for alar reconstruction after mohs micrographic surgeryespecially in an outpatient setting and.
Nasolabial flap definition of nasolabial flap by medical. Mediumsized defects of the nose can be closed by rotation flaps with skin borrowed from the glabella, upper nasal dorsum, or nasolabial sulci. While theyre extremely common, their severity can vary. 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. This technique is well suited to repair defects of the floor of the mouth up. Redundant skin extends from the medial canthus of the eye to the inferior margin of the mandible. 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. Nasolabial flap alternative uses for a classic but. Pdf a 65yearold woman with a deeply infiltrating basal cell carcinoma in the right ala underwent fullthickness excision of most of the ala. Sliding flap transferring a flap to its new position using a sliding similar to an advancement flap. Nasolabial perforator flap for onestage reconstruction of nasal. The reverse nasolabial flap with a cartilage graft for the. She is shown preop left, after the nasolabial flap middle, and 3 months after the resection of the nasolabial flap right.
Reconstruction of the nasal defects by nasolabial flaps. Superiorly based nasolabial flap for nose reconstruction. Technique of nasolabial flap insetting using a tunnel. Reconstruction was performed by using the reverse nasolabial flap and a. Patients and methods fortyseven consecutive patients 46 men and 1 woman aged between 18 and 44 years of age, were. The study includes the indications of use of the flap, flap design, technique, and the complications rate. Considerable confusion exists regarding the nature of the blood supply of the inferiorly based nasolabial flap.
Aug 08, 2019 all of them had initial interincisal opening of less than 22 mm. 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. Nasolabial flap for tongue reconstruction pjmhs online. This prospective study evaluates the efficacy of nasolabial. Its main indications are deep and extensive defects of the nasal ala. The nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors. Often overlooked as an option to use in nasal reconstruction, the nasolabial flap can be very advantageous. 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. It is commonly used as a superiorly based flap to reconstruct nasal defects and oral defects located in the upper sulcus or palate. Journal of oral and maxillofacial surgery, medicine, and. The place of nasolabial flap in orofacial reconstruction. Reconstruction of alarperialar defects with a combined. Ohtsuka editorial comment in treating defects of the face, the possibility of primary closure and even the use of split or fullthickness skin. 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 nasolabial flap is one of the most ancient techniques used in orofacial surgery. Nasolabial flap reconstruction in oral cancer world journal. Cameron editorial comment the versatility and usefulness of the nasolabial flap are well known. Nasolabial flaps in the treatment of mronj a b s t r a c t. In this procedure, skin is transplanted from the cheek to the nose in two outpatient procedures.
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. Nasolabial flaps in the treatment of mronj surgical case. Nasolabial flaps are frequently used to repair defects of the nostril and nasal tip. Inferiorly based nasolabial flap is a reliable, economical option for the management of oral submucous fibrosis borle et al, 2009. The authors report two cases of patients with skin cancer treated surgically with variations of the classic nasolabial flap. Use of nasolabial flap in intra and extraoral reconstruction. 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. Nasolabial flap for oral cavity reconstruction vula university of. A modification of the nasolabial flap islanded pedicled nasolabial flap ipnlf is an easy and reliable option fo. The nasolabial flap is a hardy flap that finds its use in the everyday reconstruction of various defects in the head and neck. The nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. 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. 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. Nasolabial flap for tongue reconstruction 321 p j m h s vol. Melolabial flap a flap from the medial cheek is used as a transposition often erroneously. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. Besides providing a good colour match, the flap is easy to dissect and inset. Jan 12, 2015 the nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. 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. Case report reversed vascular nasolabial flap pedicled with. The reverse or turnover nasolabial flap is a variant of the conven tional nasolabial flap. Versatility and reliability of islanded pedicled nasolabial. One stage reconstruction of the floor of the mouth with a. Oct 04, 2014 superiorly based nasolabial flap closure of the oro antral fistulae. Nasolabial flap, ala reconstruction, skin tumors structive surgeon 4,5,6.
Nasolabial and cheek skin flaps plastic surgery key. Postoperative physiotherapy was given to all the patients, with 1 year follow up. Nasolabial flap is a versatile flap well suited for single stage reconstruction. 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. Full thickness skin grafts give a better cosmetic result than a nasal labial flap but should only be used for small superficial defects. Oct 30, 2012 the nasolabial flap can also be used as an interpolation flap in either a single or a staged technique. The flap consist of skin subcutaneous tissue and underlying musculature the flap can be used unilaterally or bilaterally for reconstruction. 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. Defect in the anterior face, nose and upper lip, floor of the mouth oaf 48. The nasolabial flap can also be used as an interpolation flap in either a single or a staged technique. Efficacy of nasolabial flap in reconstruction of fibrotomy. Objectives reconstruction of head and neck cancer ablative defects is challenging. 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. All the surgeries were performed under 4x loupe magnification. We propose a new protocol for the management of oral submucous. Reconstruction of oral mucosal defects using the nasolabial. The nasolabial interpolation flap is an essential flap in nasal reconstruction. We present a case of lip reconstruction following a total resection of the upper lip. Arterial anatomy of the nasolabial flap keio university. Request pdf nasolabial flaps in oral reconstruction. Use of nasolabial flap in the management of oral submucous. N2 by using stereographic angiograms, the three dimensional structures of skin perforators. 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. Nasolabial flap reconstruction in oral cancer world journal of.
A subcutaneous pedicled inferiorly based nasolabial flap can provide a one stage repair. This basal cell carcinoma of the nose was excised and repaired with a nasolabial rotation skin flap. Case reports in surgery hindawi publishing corporation. The cases illustrated demonstrate a good alternative when the simpler techniques will not suffice. The skin between the defect and the flap is excised to allow the flap to reach the defect. The reverse or turnover nasolabial flap is a variant of the. Fiftyseven years later, esser 1921 described the use of the inferiorly based nasolabial flap to close palatal fistulae esser, 1921. 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. Reconstruction of alarperialar defects with a combined subcutaneous and cutaneous pedicled rotationadvancement nasolabial flap. 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. For reconstruction of the buccal mucosa, lower alveolus, tongue, or floor of the mouth where. A retrospective analysis of 26 cases of oral cancer treated with. In cases of carcinoma, the skin lesions were excised with an adequate margin.
Pdf the reverse nasolabial flap with a cartilage graft for the. Extended nasolabial flap a versatile reconstruction. Medicationrelated osteonecrosis of the jaw mronj occurs as a side effect of several drug classes, including antiresorptives and antiangiogenics. 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. Nasolabial flaps were performed in 40 patients, for reconstruction of. Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. 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.
This is more so when the resection is total and a complete lip has to be constructed. The patients were treated with bilateral release of fibrous bands, coronoidotomy, and grafting with extended nasolabial flap. 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. The bilateral inferiorly based nasolabial flap has utility in the reconstruction of the anterior defects of the floor of the mouth. In 8 of these patients, the facial artery was carefully dissected and preserved while doing. 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. Nasolabial flap is an old flap for reconstructive purposes.
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