Designed as a true myocutaneous flap pedicled on the facial artery, the nasolabial flap is a robust and versatile flap that is well suited to singlestage reconstruction of oral cavity defects or to staged recon structions of facial defects figure 1. Nose is considered to be the most complex structure on a face, considering its threedimensional topography. We propose a new protocol for the management of oral submucous. Cameron editorial comment the versatility and usefulness of the nasolabial flap are well known. It is commonly used as a superiorly based flap to reconstruct nasal defects and oral defects located in the upper sulcus or palate. 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. Research open access nasolabial flap reconstruction in. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal graft lining. Nasolabial flaps are frequently used to repair defects of the nostril and nasal tip.
Nasolabial flap reconstruction of oral cavity defects. The nasolabial interpolation flap is an essential flap in nasal reconstruction. Reconstruction of nasal ala with nasolabial perforator. Nasolabial flap is an old flap for reconstructive purposes. Nasolabial flap for tongue reconstruction 321 p j m h s vol. The histopathology revealed all margins free of tumor in the excised specimens. This article describes the successful use of pedicled nasolabial. Nasolabial flap definition of nasolabial flap by medical. O r nasolabial island flap in the management of oral.
We believe that this provides an alternative method of total upper lip reconstruction with minimal disruption of the facial aesthesis. Nasolabial flap reconstruction in oral cancer world. 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. The nasolabial flap is a pedicled flap with a wide description and application for use in lateral nasal wall, ala, columella, and intraoral reconstruction. Nasolabial flap is useful for the defect restricted to the white lip,1,2 but when the defect involves vermilion and the white lip, crosslip flap abbe flap has been commonly. This chapter will focus on oral cavity recon struction. Nasolabial flap for tongue reconstruction pjmhs online. The melolabial vy subcutaneous tissue pedicle island advancement flap is an option for repair of medial cheek skin defects at or below the level of the. Over time different modifications have been introduced to expand its usage. Arterial anatomy of the nasolabial flap keio university. The limit of flap over defect was not exceeding 5 mm. N2 by using stereographic angiograms, the three dimensional structures of skin perforators.
I got dermal filler for my nasolabial folds the file. The flap is commonly designed lateral to the nasolabial fold with the medial limit of the flap 23 mm lateral to this fold in the superiorly based nlf, the base of the flap is near the ala and. The reverse or turnover nasolabial flap is a variant of the. Use of nasolabial flap in the management of oral submucous. The reverse nasolabial flap with a cartilage graft for the. 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.
Nasolabial flap repair for alar margin defects by lyall r. Although you may not be familiar with the term nasolabial folds, you know them by their more common name laugh lines. 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. Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. The nasolabial flap may be raised as an axial flap, a random flap, or as an island flap. Nasolabial medical definition merriamwebster medical. 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. Nasolabial flap repair for alar margin defects sciencedirect. The bilateral inferiorly based nasolabial flap has utility in the reconstruction of the anterior defects of the floor of the mouth. Often overlooked as an option to use in nasal reconstruction, the nasolabial flap can be very advantageous. A total of 10 patients of oral submucous fibrosis were admitted and surgically treated in our hospital with due permission of the ethical committee.
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. The nasolabial flap has found a unique role as one of the go. The nasolabial flap is an axial flap but may be utilized as a random flap 4. 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. Closure of a large nasal septal perforation with a lined. However, these flaps have limited mobility and these limit their use in many instances. Fiftyseven years later, esser 1921 described the use of the inferiorly based nasolabial flap to close palatal fistulae esser, 1921. The nasolabial flap is a hardy flap that finds its use in the everyday reconstruction of various defects in the head and neck. The shape of the flap was generally consistent with aesthetic subunit of the defect. These are the lines we all have that run from the side of the nose to the corner of. Case report reversed vascular nasolabial flap pedicled. Nasolabial and cheek skin flaps plastic surgery key.
It dawned on me about a year ago that i never get asked for id anymore. A retrospective analysis of 26 cases of oral cancer treated with. Facial artery with its numerous small cutaneous perforators can be a source for freestyle skin flaps that can be islanded and have greater reach, one of which is nasolabial perforatory flap. The place of nasolabial flap in orofacial reconstruction. Inferiorly based nasolabial flap is a reliable, economical option for the management of oral submucous fibrosis borle et al, 2009. Despite widespread use of this invaluable flap, there are still controversies over the terms used for the description of this flap. Christie hospital and holt radium institute, manchester fullthickness defects of the ala nasi may be.
A orkhorse for the reconstruction skin margins whereas squamous cell carcinomas were excised with 6mm normal skin margins. Case reports in surgery hindawi publishing corporation. A report of 18 cases yadranko ducic, md, frcs c, and mark burye, dds purpose. Its main indications are deep and extensive defects of the nasal ala. 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. Efficacy of nasolabial flap in reconstruction of fibrotomy. In all the cases a superiorly based nasolabial flap was performed. Sliding flap transferring a flap to its new position using a sliding similar to an advancement flap. Simple makeup tips to look 10 years younger duration. Nasolabial definition of nasolabial by medical dictionary. For smaller defects of the oral mucosa in different anatomic locations of the oral cavity the nasolabial flap is a very useful and simple alternative to other pedicled flaps and free flaps.
I thought that perhaps this was owing to my burgeoning sophistication and dd s, but it was only when i spotted myself in the. In our experience nasolabial flap is a very reliable flap for the alar defects after tumor resection. In the nasolabial region are lines or creases that run between the nose and mouth and should be assessed for symmetry. Nasolabial flap is a workhorse flap for coverage of many facial units. 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. It may have also produced a longer lasting and more predictable result 3. 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. Reconstruction of the nasal defects by nasolabial flaps. However, there are limitations to the skoog procedure, which include a decreased amount of effect in the anterior cheek, nasolabial. The use of nasolabial flap nlf to reconstruct orofacial soft tissue defects is one of the oldest methods for reconstruction in the medical literature. Reconstruction of its concave and convex contour is. The nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors.
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