Clinical anatomy of the islanded pedicled nasolabial flap and its application in reconstruction of postoperative defects of T1-T2 stage carcinoma of the floor of mouth

doi:10.19439/j.sjos.2025.03.008

Abstract

Abstract: PURPOSE: To investigate the anatomic features of nasolabial flap pedicled with a facial artery and its application in repairing the defect after surgery of stage T1-T2 carcinoma of the floor of mouth. METHODS: Dissections of the maxillofacial region were performed on 8 specimens of national adults fixed with 10% formaldehyde, and the anatomical pictures were analyzed using Image-Pro Plus 6.0 software. Nine patients were retrospectively reviewed from August 2015 to January 2024 for the repair of postoperative defects of stage T1-T2 carcinoma of the floor of mouth using nasolabial fold flaps with a facial artery perforator branch as vascular pedicle. RESULTS: The external diameter of the facial artery at the lower border of the mandible was (2.05±0.98) mm. The main trunk of the facial artery traveled along the line from the beginning of the facial artery to the nasal blade and had a length of (90.89±3.79) mm. The main facial vein run along the line from the beginning of the facial artery to the medial canthus, and its length is (118.10±2.57) mm. The longest distance between the facial artery and the facial vein was (25.92±1.96) mm. Nine patients had a favourable postoperative outcomes without obvious complications. CONCLUSIONS: Repair of postoperative defects in middle-aged and elderly patients with T1-T2 stage carcinoma of the floor of mouth using a nasolabial fold flap can achieve satisfactory clinical outcomes.

Key words: Carcinoma of the floor of mouth, Islanded pedicled nasolabial flap, Cadaveric dissection, Image-Pro Plus 6.0 software

CLC Number:

R739.8
R322

Zhou Xue, Wang Weihong, Luo Zhengpeng, Zhou Zhirong, Liu Yu, Zhang Jian. Clinical anatomy of the islanded pedicled nasolabial flap and its application in reconstruction of postoperative defects of T1-T2 stage carcinoma of the floor of mouth[J]. Shanghai Journal of Stomatology, 2025, 34(3): 267-270.

References

[1] Sweeny L, Curry JM, Crawley MB, et al.Age and comorbidities impact medical complications and mortality following free flap reconstruction[J]. Laryngoscope, 2022, 132(4): 772-780.
[2] Amin AA, Jamali OM, Ibrahim AS, et al.The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: reliability and oncological outcome[J]. Head Neck, 2020, 42(10): 2920-2930.
[3] 许清华, 李浩然, 何晓, 等. 双侧面动脉穿支皮瓣在鼻中下部大面积缺损修复中的应用[J]. 中国修复重建外科杂志, 2023, 37(10): 1266-1269.
[4] Chakraborty SS, Goel AD, Sahu RK, et al.Effectiveness of nasolabial flap versus paramedian forehead flap for nasal reconstruction: a systematic review and meta-analysis[J]. Aesthetic Plast Surg, 2023, 47(1): 313-329.
[5] Reece MK, Angermayer M, Noel T, et al.Intraoral nasolabial flap for lower lip augmentation following post-radiation contracture[J]. Am J Otolaryngol, 2023, 44(2): 103703.
[6] Rahpeyma A, Khajehahmadi S.The place of nasolabial flap in orofacial reconstruction: a review[J].Ann Med Surg (Lond), 2016, 12: 79-87.
[7] Ercan A, Ercan LD, Demiroz A.Nasolabial perforator flap: a multi-tool for reconstruction of facial units[J]. J Craniofac Surg, 2020, 31(4): 1042-1045.
[8] Posso C, Delgado Anaya D, Aguilar Henao J, et al.Nasolabial propeller perforator flap: anatomical study and case series[J]. J Surg Oncol, 2018, 117(5): 1100-1106.
[9] 王卫红, 邹智荣, 刘宗良, 等. 下腹直肌皮瓣的制备及其应用解剖学研究[J]. 华西口腔医学杂志, 2010, 28(3): 522-525.
[10] 张洪荣, 王卫红, 许彪, 等. 股直肌瓣和股前外侧肌瓣的应用解剖及其修复口腔恶性肿瘤术后缺损[J]. 中华显微外科杂志, 2023, 46(3): 247-253.
[11] 尚伟, 郑家伟. 口腔及口咽癌新版TNM分期与NCCN诊治指南部分解读[J]. 中国口腔颌面外科杂志, 2018, 16(6): 533-546.
[12] 曾琳, 王卫红, 龚菊. 颌面部恶性肿瘤与颈动脉粥样硬化性病变相关性的临床探讨[J]. 实用口腔医学杂志, 2018, 34(3): 351-355.
[13] 蒋悦赟, 唐菱菱, 马中凯, 等. 血管化黏膜瓣在早-中期舌癌及口底癌缺损修复中的早期应用研究[J]. 华西口腔医学杂志, 2022, 40(2): 204-209.
[14] 罗世洪, 肖金刚, 孙黎波, 等. 股前外侧肌皮瓣及CT血管造影在修复中晚期口底癌术后缺损中的应用[J]. 华西口腔医学杂志, 2015, 33(4): 409-413.
[15] 张建伟, 周昌龙, 王永盛, 等. 舌骨下肌皮瓣在老年口腔癌术后缺损修复中的应用[J]. 上海口腔医学, 2013, 22(3): 334-337.
[16] 黄龙, 郭峰, 翦新春, 等. 颏下动脉穿支皮瓣修复口腔癌术后缺损的临床应用[J]. 中华口腔医学杂志, 2018, 53(1): 3-7.
[17] Mishra A, Shankar R, Prakash G, et al.Transposition nasolabial flap: a versatile flap for sensate reconstruction of lip defects[J]. Head Neck, 2022, 44(11): 2473-2480.
[18] Dhara V, Kudva A, Chithra A, et al.Reconstruction of buccal mucosa: a minimalist symbiotic approach with local flaps[J]. Oral Oncol, 2021, 114: 105081.
[19] Chakrabarti S, Gupta DK, Gupta M, et al.Versatility and reliability of islanded pedicled nasolabial flap in head and neck cancer reconstruction[J]. Laryngoscope, 2020, 130(8): 1967-1972.
[20] Nueangkhota P, Liang YJ, Zheng GS, et al.Reconstruction of tongue defects with the contralateral nasolabial island flap[J]. J Oral Maxillofac Surg, 2016, 74(4): 851-859.
[21] 傅素静, 兰行简, 高景恒, 等. 鼻唇沟区域解剖学研究[J]. 中华整形烧伤外科杂志, 1999, 15(2): 145-147.
[22] Thakkar M, Rose A, Bednarz B.Thromboelastography in microsurgical reconstruction: a systematic review[J]. JPRAS open, 2022, 32: 24-33.
[23] 刘先伟, 武媛, 潘剑, 等. 鼻唇沟皮瓣修复口腔颌面部软组织缺损的临床研究[J]. 口腔医学研究, 2013, 29(2): 159-163.
[24] Ioannides C, Fossion E.Nasolabial flap for the reconstruction of defects of the floor of the mouth[J]. Int J Oral Maxillofac Surg, 1991, 20(1): 40-43.