Bilateral inferiorly based nasolabial flaps for full-thickness reconstruction of large lower lip defects following tumour resection

Objective

To report on the feasibility and outcomes of using inferiorly based nasolabial flaps for the reconstruction of large lower lip defects following tumour resection.

Methods

Using a retrospective cohort study design, we enrolled a cohort of patients with large lower lip squamous cell carcinoma who underwent ablative tumour resection and full-thickness reconstruction with bilateral nasolabial flaps at Mansoura University Oncology Centre and Mansoura Health Insurance Hospital between June 2023 and August 2024. The predictor variables were categorized as preoperative, operative, or postoperative variables. The outcomes of interest were oral competence, wound dehiscence, flap necrosis, reoperation, and tumour recurrence. Appropriate statistics were computed using a cut-off value of 0.05.

Results

The study included six patients with a mean age of 62.5 ± 10.3 years and a mean body mass index (BMI) of 29.93 ± 1.7 kg/m². The average tumour size was 4.7 ± 0.8 cm. All patients were male smokers who smoked more than twenty cigarettes per day. Two operations were complicated with partial flap necrosis (33.3 %), and three patients (50 %) experienced minimal drooling, which improved over time. Only BMI and tumor grade showed a significant relationship with the incidence of postoperative complications (P = 0.009, 0.006, respectively). A good aesthetic outcome was observed in all cases.

Conclusion

Based on this small cohort, the bilateral inferiorly based nasolabial flap technique is a safe and easily harvested option that provides acceptable functional and cosmetic outcomes, with minimal donor site morbidity, for the reconstruction of large lower lip defects following tumour resection. It could be an alternative to other longer or more aggressive treatment methods, such as microsurgery, for elderly patients or those with medical comorbidities.