Revisiting the Diversity of Nasolabial Flaps in Reconstructive Surgery

TL;DR

The study explores the effectiveness of nasolabial flaps in reconstructive surgery for facial and oral defects, especially in patients with health complications.

Contribution

The paper highlights the versatility and reliability of nasolabial flaps in reconstructive surgery for patients with comorbidities.

Findings

Nasolabial flaps were successfully used for various facial and intraoral defects without flap necrosis.

The flaps provided good aesthetic and functional outcomes in patients with multiple comorbidities.

They are particularly useful for smaller defects and in patients where free flaps are not feasible.

Abstract

Background: The nasolabial flap is a regional flap with vascularity based on the facial artery inferiorly and the angular artery superiorly. Depending on the area to be covered, it can be islanded or pedicled and performed in a single-stage or two-stage procedure. The tissue laxity in this area provides a wider arc of rotation, and the good color match adds to the other advantages of this flap. Generally, it is used to cover nasal, lip, and alveolar defects. It is especially useful in patients with multiple comorbidities, in whom major flaps cannot be planned.

Methodology: This is a retrospective descriptive study of 19 patients who underwent closure of various facial and intraoral defects with nasolabial flaps and were admitted to a tertiary care hospital between January 2019 and March 2024. The various parameters analyzed were the age, gender, comorbidities, size of defect, duration of hospital stay, wound dehiscence, flap necrosis, and the type of nasolabial flap that was used.

Results: In patients in whom the facial defects were small and when free flaps were not possible due to poor general conditions and comorbidities, nasolabial flaps were used. Wound healing was good with no flap necrosis. Nasolabial flaps were used for covering defects over the dorsum, root, and ala of the nose, tongue, hard palate, buccal mucosa, glabella, upper and lower lip, and angle of the mouth.

Conclusion: Nasolabial flaps are highly robust and useful in patients with comorbidities and for smaller defects. They provide good aesthetic and functional outcomes in all patients.

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