Versatility and Reliability of Islanded Pedicled Nasolabial Flap in Head and Neck Cancer Reconstruction
- 1 August 2020
- journal article
- research article
- Published by Wiley in The Laryngoscope
- Vol. 130 (8), 1967-1972
- https://doi.org/10.1002/lary.28662
Abstract
Objectives Reconstruction of head and neck cancer ablative defects is challenging. A modification of the nasolabial flap (islanded pedicled nasolabial flap [ipNLF]) is an easy and reliable option for reconstruction of small- to medium-sized defects of the head and neck, especially in resource-constrained and high-volume centers. Study Design and Methods We present the retrospective analysis of 27 consecutive patients reconstructed with ipNLF at two high-volume cancer centers, Homi Bhabha Cancer Hospital, Varanasi, India; and Army Hospital Research and Referral, New Delhi, India. The functional outcomes measured were duration of weaning of feeding and tracheotomy tubes and speech assessment (speech intelligible rating score [SIR]) postsurgery. Complications assessed were flap loss, orocutaneous fistula, donor site wound dehiscence, oral incompetence, and angle of mouth deviation. Results The most common ablative defect was of the oral cavity (22 patients), followed by the oropharynx (4 patients) and hypopharynx (1 patient). The mean operating time for flap harvesting and insetting was 57.7 minutes. The mean durations for postoperative feeding tube and tracheotomy removal were 10 and 5 days, respectively. Twenty-four subjects had SIR scores of I or II. None of the subjects had flap loss, orocutaneous fistula, or donor site wound dehiscence. Twenty-five subjects had no oral incompetence, and 26 subjects had no or minimal angle of mouth deviation. Conclusion This is the largest series of ipNLF to date and emphasizes the versatility, reliability, reproducibility and excellent functional and acceptable cosmetic outcomes of this flap for the reconstruction of judiciously chosen head and neck ablative defects. Level of Evidence 2CLaryngoscope, 130: 1967-1972, 2020Keywords
This publication has 12 references indexed in Scilit:
- Infrahyoid flap in oropharyngeal reconstruction following carcinoma resection: A study of 6 patients and literature reviewOncology Letters, 2016
- Supraclavicular artery island flap in head and neck reconstructionEuropean Annals of Otorhinolaryngology, Head and Neck Diseases, 2015
- Reconstruction of Tongue Defects With the Contralateral Nasolabial Island FlapJournal of Oral and Maxillofacial Surgery, 2015
- Speech and swallowing following tongue cancer surgery and free flap reconstruction – A systematic reviewOral Oncology, 2013
- Reconstruction of defects in the head and neck with free flaps: 20 years experienceBritish Journal of Oral and Maxillofacial Surgery, 2007
- Analytic Review of 2372 Free Flap Transfers for Head and Neck Reconstruction Following Cancer ResectionJournal of Reconstructive Microsurgery, 2003
- Nasolabial flaps in oral reconstruction: an analysis of 224 casesBritish Journal of Plastic Surgery, 2001
- The Nasolabial Flap Revisited as an Adjunct to Floor-of-Mouth ReconstructionAnnals of Plastic Surgery, 2001
- New Buccinator Myomucosal Island Flap: Anatomic Study and Clinical ApplicationPlastic and Reconstructive Surgery, 1999
- Nasolabial flap in intraoral reconstruction: Review of 55 casesThe American Journal of Surgery, 1981