The nasolabial flap is an excellent choice for use in. 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. Majority of nasolabial flaps have random pattern blood supply. Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. This flap is often classified as an axial flap because there is a named artery.
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. Nasolabial flaps are frequently used to repair defects of the nostril and nasal tip. O r nasolabial island flap in the management of oral. The nasolabial fold flap was raised from the nasolabial fold 2cm in width up to the base of the ala. Nasolabial skin flaps to the cheek plastic surgery key. Nasolabial flap can have different thicknesses from full thickness cheek to thin dermis and. Errors in design and construction of this flap have caused many to condemn it and move away from its use. The intervening skin between the two defects was excised. We believe that this provides an alternative method of total upper lip reconstruction with minimal disruption of the facial aesthesis.
Research open access nasolabial flap reconstruction in. The nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. 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. For reconstruction of the buccal mucosa, lower alveolus. The nasolabial flap has been a mainstay in reconstructing nasal defects. A preoperative view and b postoperative view following wide excision and reconstruction. The nasolabial flapa defensive reappraisal field 1990. During flap preparation, the edges of the defect should be reverticalized.
The bilateral inferiorly based nasolabial flap has utility in the reconstruction of the anterior defects of the floor of the mouth. Reconstruction of the anterior floor of the mouth with the. A nasolabial perforator flap based on nasolabial artery perforasome was used to cover this defect. The nasolabial flap can also be used as an interpolation flap in either a single or a staged technique.
The first and the foremost technique that is thought for the reconstruction of maxillofacial. Pdf nasolabial flap reconstruction in oral cancer researchgate. We propose a new protocol for the management of oral submucous. Its reliable blood supply, minimal donor site morbidity, and excellent texture and color match are some of the advantages of this local flap.
Full thickness skin grafts give a better cosmetic result than a nasal labial flap but should only be used for small superficial defects. The nasolabial flap has widely been used for an sized defect of the cheek, upper and lower lip, palate, and especially, the anterior floorof the mouth. N2 by using stereographic angiograms, the three dimensional structures of skin perforators. Case reports in surgery hindawi publishing corporation. 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 reverse or turnover nasolabial flap is a variant of the. Prefabricated nasolabial flap for reconstruction of full. The place of nasolabial flap in orofacial reconstruction. Find, read and cite all the research you need on researchgate. Pdf the nasolabial flap was described 170 years ago and still remains one. Nasolabial and cheek skin flaps plastic surgery key. Nasolabial definition of nasolabial by medical dictionary. In the nasolabial region are lines or creases that run between the nose and mouth and should be assessed for symmetry. Fiftyseven years later, esser 1921 described the use of the inferiorly based nasolabial flap to close palatal fistulae esser, 1921.
Arterial anatomy of the nasolabial flap keio university. Technique of nasolabial flap insetting using a tunnel. The nasolabial flap is a simple flap used for reconstructing. Nasolabial flap reconstruction in oral cancer ncbi. Ohtsuka editorial comment in treating defects of the face, the possibility of primary closure and even the use of split or fullthickness skin. The flap was then rotated across the midline of the nose and secured to the perichondral flap. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal graft lining.
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. 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. To minimise the arc of rotation, the flap was designed adjacent to the defect site and its skin paddle was. Nasolabial flap for tongue reconstruction 321 p j m h s vol.
Flaps for oral and maxillofacial reconstruction thieme connect. Reconstruction of the nasal defects by nasolabial flaps. Efficacy of nasolabial flap in reconstruction of fibrotomy. He is shown preop left, immediately following surgery.
Research open access nasolabial flap reconstruction in oral cancer seema singh, rajesh kumar singh and manoj pandey abstract background. Often overlooked as an option to use in nasal reconstruction, the nasolabial flap can be very advantageous. Reconstruction of nasal skin cancer defects with local flaps. The twostage nasolabial flap for subunit reconstruction of the ala. Nasolabial flaps in oral reconstruction journal of plastic. Reconstruction of nasal ala with nasolabial perforator. Pdf background the nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant. Nasolabial rhomboid flaps have been used successfully in seven patients. Disadvantages of the nasolabial flap are that there is a limited amount of tissue available. Pdf the nasolabial flap was described 170 years ago and still remains one of the most frequently used methods in facial reconstruction. This article reaffirms its extensive applicability and seeks to forestall unaesthetic reconstructions by consideration of preventive steps.
Sliding flap transferring a flap to its new position using a sliding similar to an advancement flap. Case report reversed vascular nasolabial flap pedicled. The choice between the two will depend on the location of the defect and the arc of rotation needed to reach it with the least amount of tension. This patient is an 89yearold gentleman with a large squamous cell carcinoma of the right lateral nasal area. In our experience nasolabial flap is a very reliable flap for the alar defects after tumor resection. Various local and distant flaps have been described for this purpose. All defects were restored by the reversed nasolabial flap pedicled with the superior labial artery. The nasolabial flap is a simple option for the reconstruction of selected oral defects. Besides providing a good colour match, the flap is easy to dissect and inset. In this procedure, skin is transplanted from the cheek to the nose in two outpatient procedures. The nasolabial flap is a hardy flap that finds its use in the everyday reconstruction of various defects in the head and neck. Case report reversed vascular nasolabial flap pedicled with. Nasolabial flap reconstruction in oral cancer world. Reconstructions in all instances have been of high quality, and no revisions have been required after at least 6 months of.
Nasolabial medical definition merriamwebster medical. Nasolabial flap, ala reconstruction, skin tumors structive surgeon 4,5,6. The nasolabial interpolation flap is an essential flap in nasal reconstruction. Mohs excisions can leave behind flat or obtuse edges, which make flap inset. For oral cavity reconstruction, the use of an inferi orly based nasolabial flap is preferred. Nasolabial flap for tongue reconstruction pjmhs online. Considerable confusion exists regarding the nature of the blood supply of the inferiorly based nasolabial flap. Nasolabial flap for oral cavity reconstruction vula university of.
Melolabial flap a flap from the medial cheek is used as a transposition often erroneously. It is commonly used as a superiorly based flap to reconstruct nasal defects and oral defects located in the upper sulcus or palate. Cameron editorial comment the versatility and usefulness of the nasolabial flap are well known. The technique that thornton and weathers introduced has a fast learning. Its main indications are deep and extensive defects of the nasal ala. A modest excess of skin and subcutaneous fat is available in the nasolabial fold for reconstruction of alar defects. The nasolabial flap is one of the most frequently used flaps in reconstruction of small. The reverse nasolabial flap with a cartilage graft for the. Nasolabial flap definition of nasolabial flap by medical. A report of 18 cases yadranko ducic, md, frcs c, and mark burye, dds purpose. The nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors. This prospective study evaluates the efficacy of nasolabial. A retrospective analysis of 26 cases of oral cancer treated with. Use of nasolabial flap in the management of oral submucous.
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