Clinical Application Of The Nasolabial Flap To Reconstruct The Lower 1/2 Defects Of The Nose

Objective: Investigate the clinical application of the nasolabial flap to reconstruct the lower 1/2 defects of the nose.Methods: Thirteen cases of lower 1/2 defects of the nose were operated on with nasolabial flap. The age were ranged from 13-60, and the average of them was 35-year-old. 5 of them were caused by trauma and 8 of them got defects after tumor resection, the areas were 1.2cm×1.0cm-2.8cm×1.5cm. 3 of them were full thickness defects. The random flap were used in 4 cases, and 8 with lateral nasal artery pedicle flap (include 3 island flap). The flap size ranged from 1.5cm×2.5cm -2.5cm×7.0cm. The follow-up period was 12 to 30 months.The reconstruction was performed with random pattern flap, a lateral nasal artery axial pedicle flap and island flap. The course of the facial artery is traced on the nasolabial region with a Doppler probe. The appropriate flap is chosen, the incision is outlined, and the periphery of the flap is infiltrated with 1% lidocaine. After the skin incision, the flap is elevated from the medial side. After identification of the facial artery and the origin of the lateral nasal artery, the pedicle is prepared carefully. Turn over the skin where the flap was passed through or the tip of the axial flap as the inner lining of the nostril. The island flap is passed through the tunnelto cover the nasal tip and alar defect and set in place with 5-0 nylon sutures. The donor area is closed primarily and a small drain is kept under the pedicle for 24 hours.Results: There was no partial or total loss of the flap. There was no distortion on the face caused by smiling and pursing of the lips observed. Donor and reconstructed areas have an excellent appearance in most cases. 79.6% of the patients were very satisfied with the results. The patient satisfaction score are higher than the objective index score given by the doctor.Conclusions:1. The reconstruction result of the lower 1/2 defect of the nose using the nasolabial flap was excellent.2. Choose different kinds of the nasolabial flap to reconstruct different defects. Artery pedicle flaps have a satisfactory blood supply, and for that reason, the required tissue can be raised for reconstruction of large defects of the nose, especially the combined defects of the subunits.3. Island flap avoid the revision of the clumsy pedicle, improve the contour of the nose.4. Turn over the skin where the flap was passed through or the tip of the axial flap as the inner lining of the nostril.5.Using the nasolabial flap to reconstruct the lower 1/2 defects of the nose can ignore the subunit principles in some extent, in order to maximal conservation of native tissue.