# Outcomes of Using Nasolabial Flap for Orofacial Reconstruction: A Retrospective Descriptive Case Series

## TL;DR

This study evaluates the effectiveness of the nasolabial flap for reconstructing orofacial defects, finding it generally reliable but requiring caution with blood supply in certain cases.

## Contribution

The study provides new clinical insights into the reliability and complications of nasolabial flap use in orofacial reconstruction.

## Key findings

- The nasolabial flap achieved satisfactory functional and aesthetic outcomes in 20 cases.
- Only 5% partial flap dehiscence and 10% distal flap necrosis were observed, primarily in cases with facial artery ligation.
- Flap survival was successful in all cases despite some complications.

## Abstract

Purpose

This retrospective descriptive study aimed to evaluate the clinical outcomes, complication rates, and flap survival of the nasolabial flap used for reconstruction of various orofacial soft-tissue defects, with particular attention to the flap design (tunneled island flap vs pedicled flap) and the impact of facial artery ligation.

Patients and methods

A total of 20 cases at the Department of Oral and Maxillofacial Surgery, National Defense Medical College Hospital, between 2017 and 2025, in which the nasolabial flap was used to reconstruct soft-tissue defects, resulting from oral cancer, jaw osteonecrosis, soft-tissue defects due to trauma, and oronasal fistula, were retrospectively reviewed after obtaining ethical approval from the ethics committee.

Results

A total of 17 cases involved intraoral reconstruction using a tunneled island flap. Meanwhile, the pedicled flap was used in three cases for lip reconstruction. In all cases, the flap survived, and satisfactory functional and esthetic outcomes were achieved. In three cases, flap resection was required after reconstruction, and only one (5%) patient developed partial flap dehiscence. Two (10%) patients exhibited distal flap necrosis, both of which involved random-pattern and tunneled island flaps in patients who had their facial artery ligated, but the flap’s viability was ultimately good. All cases of orofacial reconstruction using the nasolabial flap during the study period were included.

Conclusions

Based on our study, the nasolabial flap is a reliable reconstructive method for orofacial defects. However, we believe that cautious attention to blood supply is needed in cases involving tunneled island flaps where the facial artery is ligated.