Please cite this article in press as: Maria L, et al. Nasolabial pedicled compared with island flaps for intraoral reconstruction of
oncological defects: complications, recovery of sensitivity, and assessment of quality of life. Br J Oral Maxillofac Surg (2016),
http://dx.doi.org/10.1016/j.bjoms.2016.04.017
ARTICLE IN PRESS
YBJOM-4866; No. of Pages 5
British Journal of Oral and Maxillofacial Surgery xxx (2016) xxx–xxx
Available online at www.sciencedirect.com
ScienceDirect
Nasolabial pedicled compared with island flaps for intraoral
reconstruction of oncological defects: complications,
recovery of sensitivity, and assessment of quality of life
Lazaridou Maria
a,*
, Vaxtsevanos Konstantinos
a
, Dimitrakopoulos Ioannis
a
,
Lazaridis Nikolaos
a
, Antoniades Konstantinos
a
a
Aristotle University of Thessaloniki, Greece
Accepted 14 April 2016
Abstract
Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defects in terms of postoperative complications,
recovery of sensitivity, and quality of life. We organised a retrospective cohort study of 49 patients who had had intraoral reconstruction with
nasolabial pedicled (n- = 13) and island (n = 36) flaps. Twenty- two patients filled in a validated quality-of-life (QoL) questionnaire and we
did sensitivity tests (sharp discrimination with the aid of a Semmes-Weinstein
TM
aesthesiometer). Descriptive and bivariate statistics were
computed and probabilities of 0.05 were accepted as significant. There were 11 flap-related complications (22%), and the flap was totally
necrotic in three patients (6%), all of whom had island flaps. There was a significant association between flap-related complications and the
use of reconstruction plate p = 0.001, 95% CI 2.36 to 11.37) and advanced stage (T3 and T4 p = 0.01, 95% CI 1.45 to 5.26). Skin sensitivity
recovered in both island and pedicled flaps. Patients treated with island flaps had significantly more problems with prosthetic rehabilitation
than those treated with pedicled flaps.
The relatively low morbidity and adequate functional and aesthetic results make the pedicled nasolabial flap a viable technique. De-
epithelialisation of the pedicle in island flaps permits coverage of defects with unilateral flaps in a one-stage reconstruction. However, the
pedicle may be excessively stretched, leading to ischaemic complications.
© 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Keywords: Pedicled nasolabial flap; Islanded nasolabial flap; Intraoral reconstruction; Quality of life; Flap-related complications
Introduction
The nasolabial flap is a dermocutaneous flap with a
random vascular supply, which relies on a rich subcu-
taneous and dermal vascular system that is supplied by
*
Corresponding author. Iposminagou Ioannou Hatzoudi 9, 567 27,
Neapoli, Thessaloniki, Greece. Tel.: +00302310619416.
E-mail addresses: lazaridoudm@yahoo.gr (L. Maria),
vaxtseva@dent.auth.gr (V. Konstantinos), idim@dent.auth.gr
(D. Ioannis), lazarnik@dent.auth.gr (L. Nikolaos), antoniad@dent.auth.gr
(A. Konstantinos).
the angular, the infraorbital, the transverse facial, and the
infratrochlear artery. This network is also augmented by
branches of the contralateral superior and inferior labial
arteries.
1–3
The flap has been used to cover intraoral defects after
resection of oral cancer, either as a pedicled flap in a two-stage
reconstruction or as an island flap in a one-stage reconstruc-
tion. We present here 49 oral reconstructions using pedicled
and island flaps in an effort to identify possible risk factors
for flap-related complications and to compare pedicled and
island flaps in terms of complications, recovery of sensitivity,
and aesthetic and functional outcome.
http://dx.doi.org/10.1016/j.bjoms.2016.04.017
0266-4356/© 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.