Nasolahial flap in reconstruction of oral defects after ablative surgery in patients with oral cancer

ABSTRACT

This study highlights technical aspects and outcome of different types of nasolabial flap in reconstruction of oral cavity defects, following extirpation of mouth cancer. This is a prospective study, included 14 patients who had been treated surgically for oral cancerous lesions and reconstruction was performed by 16 nasolabial flaps in the period from June 2002 and December 2005 in Sohag University Hospital. Inferiorly based flaps were 10 unilateral and 1 bilateral, and superiorly based flaps were 2 unilateral and 1 bilateral. All flaps were for immediate reconstruction of the defects except in 2 cases. Perioperative complications were recorded. Functional outcome in terms of speech; chewing; swallowing; and cosmetic appearance were evaluated preoperatively and at 6 months postoperative. Patients were 10 men and 4 women and their average age was 63.8 years [45-82 years]. The commonest histology was squamous cell carcinoma [12/14] and presentation was early in stage I [6/14] and II [5/14]. The majority of patients were ASA grade II [5/14] and III [6/14]. Neck lymph nodes dissection with facial artery ligation was done in 8 patients without affecting the outcome. As complications, we noted one case with postoperative wound dehiscence and another case with minimal infection. On the other hand, we, found it technically feasible, versatile, and with satisfactory functional and acceptable cosmetic outcome. The nasolabial flap for replacement of soft tissue in the oral cavity is easy to harvest, with minimal morbidity. It represents a functional and aesthetically satisfactory alternative to reconstruction by other flaps in cases with small and medium sized defects, especially in elderly, medically compromised patients who are therefore of poorer surgical risk