The nasolabial flap revisited as an adjunct to floor-of-mouth reconstruction.

Composite free tissue reconstruction for floor-of-mouth defects are thought of as single-stage procedures. However, postoperative wound complications often require additional soft-tissue coverage to salvage the initial reconstruction. Nasolabial flaps interpolated into the oral cavity offer an expedient solution to soft-tissue deficits encountered during complicated floor-of-mouth reconstructions. The records of 39 patients undergoing free tissue reconstruction, from July 1995 to December 1999 at Shands Hospital and the Gainesville VA Medical Center, for floor-of-mouth defects were reviewed. Six patients developed postoperative wound complications that compromised the initial reconstruction. In all patients, inferiorly based nasolabial flaps were used to provide additional soft-tissue coverage and wound closure. Radiation therapy and facial artery ligation did not affect the outcome. Complete wound healing and salvage of the initial reconstruction was achieved in all 6 patients.