Akhilesh Kumar Singh, Nitesh Mishra, Janani T, Naresh Kumar Sharma, Arun Pandey. Reconstruction of Large Lower Lip Defect with Bilateral Nasolabial Flap: A Report of Case Series. Int
J Dentistry Oral Sci. 2020;7(8):790-793.
790
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Reconstruction of Large Lower Lip Defect with Bilateral Nasolabial Flap: A Report of Case Series
Case Report
Akhilesh Kumar Singh
1
, Nitesh Mishra
2*
, Janani T
3
, Naresh Kumar Sharma
4
, Arun Pandey
5
1
Assistant Professor, Department of Oral and maxillofacial surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu Univer-
sity, India.
2
Oral and maxillofacial surgery,Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, India.
*Senior Resident, Department of Dentistry, Kalpana Chawla Govt. Medical College and Hospital, Karnal, Haryana, India.
3
Junior Resident, Department of Oral and Maxillofacial surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University,
India.
4
Professor, Department of Oral and Maxillofacial surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, India.
5
Senior Resident, Trauma Center and Superspeciality Hospital, Institute of Medical Sciences, Banaras Hindu University, India.
International Journal of Dentistry and Oral Science (IJDOS)
ISSN: 2377-8075
Introduction
Nasolabial fap (NLF) appears to have been originally described
in the works of Susruta in 600 BC [1]. It was there after used
primarily in external reconstruction of nose for centuries. The
transbuccal use of nasolabial fap for the closure of the oral cavity
was frst described by Thiersch [2].
There are various modalities that have been described for recon-
structing the intra and extra-oral defects that cannot be managed
by primary closure. They can be either pedicled or free faps,
however, sometimes these techniques are not feasible because
either defect is too small or patient’s age and medical status do
not permit a lengthy anaesthetic and surgical procedure. In such
circumstances nasolabial fap stands the only available option, that
can serve the situation for repair of small or moderate-sized local
intra and extra-oral defects [3].
Very large defects of the lip are diffcult to reconstruct. The main
goal of a lip reconstruction is to re-establish aesthetics and oral
competency that can allow normal function. Although several
methods of lip reconstruction has been described in the litera-
ture, no technique has been proven to be the ideal one that suf-
fces all requirements. Many authors advocate musculocutaneous
tissue transfer to recreate the anatomical component of the lip, as
they believe that the muscle must be transferred into the defect to
maintain oral competence [4]. The technique of composite tissue
transfer (e.g. Karapandzic fap) is interesting but its use is limited,
as the quantity of orbicularis oris muscle is sparse and these pro-
cedures often lead to signifcant microstomia [5]. Limited quantity
of muscle often get denervated during secondary commissuro-
plasties, which is performed to correct microstomia. Final result
after many procedures often ends in patients with an immobile
*Corresponding Author:
Dr. Nitesh Mishra,
Senior Resident, Room no.16, Block B, Resident Doctor Hostel, Kalpana Chawla Government, Medical College and Hospital, Karnal, Haryana, Pincode-132001, India.
Tel: 8840039760
E-mail: mishranit25@gmail.com
Received: July 25, 2020
Accepted: August 23, 2020
Published: August 29, 2020
Citation: Akhilesh Kumar Singh, Nitesh Mishra, Janani T, Naresh Kumar Sharma, Arun Pandey. Reconstruction of Large Lower Lip Defect with Bilateral Nasolabial Flap: A Report
of Case Series. Int J Dentistry Oral Sci. 2020;7(8):790-793. doi: http://dx.doi.org/10.19070/2377-8075-20000155
Copyright: Nitesh Mishra
©
2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
In the present era of medical advancement, the concept of a microvascular free fap technique has signifcantly gained popu-
larity in the reconstruction of head and neck surgical defects. Therefore, the routine need for various local and regional faps
that were previously in use, has decreased to a considerable extent. However, a number of such local and regional faps are
quite useful and are still in practice, being used by the reconstructive surgeons. Nasolabial fap is a versatile, reliable, simple,
easy to harvest local fap that can cover a variety of intra and extraoral defects. In this case series, we present the success and
utility of bilateral nasolabial fap in reconstruction of two large lower lip defects and the restoration of function and aesthetics.
The patients had been followed for one year, which was uneventful with no signs of recurrence.
Keywords: Squamous Cell Carcinoma; Lower Lip Defect; Bilateral Nasolabial Flap.