W H Lindsey1. 1. Department of Otolaryngology Head-Neck Surgery, University of Virginia Medical Center, McLean, USA. drlindsey@novafaces.com
Abstract
OBJECTIVE: To review a series of alar reconstruction cases in which the melolabial flap was used. DESIGN: Case series. SETTING: University medical center and private practice. PATIENTS: One hundred five consecutive patients with alar defects, resulting from oncologic resection, in whom melolabial flap reconstruction was suitable. INTERVENTION: Single-stage melolabial flap reconstruction by a single surgeon (W.H.L.). MAIN OUTCOME MEASURE: Viability of the flap and presence or absence of surgical complications. RESULTS: There were no complete flap failures. Seven patients had partial necrosis of the distal end of the flap, and 3 of these instances occurred when the flap was rolled back onto itself to reconstruct the nasal vestibule; however, none of the patients required a subsequent operation or notching. Three patients developed hematoma, and 2 of them required a return to the operating room for control of bleeding. Four patients developed superficial infection, and 1 developed cellulitis of the cheek requiring opening of the wound and later revision of the flap. This was the only flap requiring revision. Fifteen patients required 3 or fewer corticosteroid infiltrations postoperatively for flap pin-cushioning or scar hypertrophy. CONCLUSION: The melolabial flap is a reliable tool in the reconstructive armamentarium of the facial plastic surgeon.
OBJECTIVE: To review a series of alar reconstruction cases in which the melolabial flap was used. DESIGN: Case series. SETTING: University medical center and private practice. PATIENTS: One hundred five consecutive patients with alar defects, resulting from oncologic resection, in whom melolabial flap reconstruction was suitable. INTERVENTION: Single-stage melolabial flap reconstruction by a single surgeon (W.H.L.). MAIN OUTCOME MEASURE: Viability of the flap and presence or absence of surgical complications. RESULTS: There were no complete flap failures. Seven patients had partial necrosis of the distal end of the flap, and 3 of these instances occurred when the flap was rolled back onto itself to reconstruct the nasal vestibule; however, none of the patients required a subsequent operation or notching. Three patients developed hematoma, and 2 of them required a return to the operating room for control of bleeding. Four patients developed superficial infection, and 1 developed cellulitis of the cheek requiring opening of the wound and later revision of the flap. This was the only flap requiring revision. Fifteen patients required 3 or fewer corticosteroid infiltrations postoperatively for flap pin-cushioning or scar hypertrophy. CONCLUSION: The melolabial flap is a reliable tool in the reconstructive armamentarium of the facial plastic surgeon.