Infolding of Nasolabial Flap: An Excellent Surgical Technique for Full-Thickness Defect of the Lip
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CLINICAL REPORT
Infolding of Nasolabial Flap: An Excellent Surgical Technique for Full-Thickness Defect of the Lip Pradeep Pradhan1
•
Sidharth Pradhan1 • Dillip Kumar Samal1
Received: 6 October 2020 / Accepted: 9 November 2020 Ó Association of Otolaryngologists of India 2020
Abstract To find out the usefulness of the infolding technique of nasolabial flap to reconstruct full-thickness defects of the lower lip. It is a retrospective analysis of 5 surgically operated cases. The infolding nasolabial flaps were utilized for the full thickness defect over the lower lip in carcinoma of the oral cavity from January 2018 to July 2019. The patients were followed up for a minimum period of 12 months, and the outcomes were evaluated. The mean age of the patients was 39.72 ± 7.58 years (range 30–52 years). The infolding nasolabial flap has used each case for the reconstruction of the lower lip. The average length and breadth of the flaps were 65 mm (range 60–75 mm) and 35 mm (range 30–40 mm), respectively. One patient presented with partial necrosis of the flap its tip. The functional and cosmetic outcomes were found satisfactory till 12 months of follow-up, and none of the patients had a recurrence of the disease. Infolding of the nasolabial flap can be a good surgical technique for the reconstruction of the full-thickness defect of the lower lip, ensuring satisfactory functional and cosmetic outcomes without causing major intraoperative/postoperative complications in patients with carcinoma of the lower lip. Keywords Infolding technique Nasolabial flap Outcome
& Pradeep Pradhan [email protected] 1
Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha 751019, India
Introduction Reconstruction of the lip remains a big challenge, especially for larger defects involving the full thickness of the lip [1, 2]. Various surgical techniques and flap designs have been previously described for the reconstruction of the lower lip, such as the Abbe–Estlander flap, Karapandzic flap, Bernard-Burow’s procedure, Gillies fan flap, advanced/rotated regional flaps and free flap reconstruction associated with respective advantages and disadvantages [2–5]. Amongst them, the nasolabial flap is considered a unique flap for the reconstruction of the lower lip, providing adequate functional and aesthetic results. Nasolabial flap (NLF) is an arterialized flap that may be superiorly based, inferiorly based [6], or centrally based [7], depending upon the arterial pedicle, although many authors have claimed a random blood supply without any definitive arterial pedicle. First described by Sushruta in 600 BC, [7] this flap has been used in the reconstruction of the floor of mouth, palate, tongue, lips, and tip and ala of the nose [1–3, 6, 8]. As the flap is very thin, it can be suitably used for the reconstruction of the partial defect over the lip. In contrast, in the full-thickness defects of the lower lip, the aesthetic outcomes are not very encouraging as it does not provide the bu
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