Different modalities of nasolabial flaps in nasal-defect reconstruction: clinical experience in 40 cases and review of literature

Background
Nasal-defect reconstruction is a challenging subject, nasolabial flaps are common methods for nasal reconstruction. Different modalities of nasolabial flaps were identified as V–Y advancement, superiorly or inferiorly based, freestyle perforator based, interpolated flap, and propeller types are commonly used.
Objective
The objective of the study is to evaluate the different modalities of nasolabial flaps in nasal-defect reconstruction and review of literature about nasal reconstructions with nasolabial flaps defining the advantages and disadvantages for each subunit.
Patients and methods
The study included 40 patients presented with nasal defects admitted to Benha University Hospital in the period from December 2018 to December 2020. Patients were reconstructed with different nasolabial flap types.
Results
In total, 40 patients whose nasal defects were reconstructed with nasolabial flaps were included in this study. The most frequent lesion was basal-cell carcinoma (73.3%). The most frequent flap type was superiorly based flap (60.0%), followed by inferiorly based flap (23.3%), and freestyle perforator nasolabial island flap was the least frequent one (16.7). All patients (100.0%) reported good functional outcomes such as normal breathing and no airway obstruction. About half of the patients reported excellent outcomes (53.3%). Partial wound dehiscence in three (7.5%) patients and alar distortion in two (5%) patients.
Conclusion
V–Y-advancement flap and freestyle perforator-based flap may be preferred for sidewall-and dorsum-defect reconstruction. Two-stage interpolation type gives the best results for tip-region defects. Propeller and transposition (superior or inferior based) type flaps may be the choice for treatment in alar-region defects.