title: The nasolabial flap as a one-stage procedure for reconstruction of intermediate-to-large lip defects with functional and aesthetic assessments.
abstract: OBJECTIVE
  The primary function of the lip is oral competence. The lips are also fundamental in facial aesthetics. Thus in lip reconstruction, it is paramount to achieve both good functional and aesthetic outcomes. Local flaps are able to provide the best tissue match in intermediate and large lip defects. Nevertheless, there has been limited literature on using the musculocutaneous nasolabial flap as a one-stage procedure for lip reconstruction.
  
  
  METHODS
  The authors recruited 21 patients who underwent a one-stage nasolabial musculocutaneous flap reconstruction for lip defects for the study. The modiolus at the mouth angle was preserved and the nasolabial flap was de-epithelised and tunnelled subcutaneously in all patients for reconstructing the lips. Electromyography was performed for 14 flaps to detect muscle activity. Oral competency was assessed using the Drooling Rating Scale and aesthetic outcomes were also analysed postoperatively with the Patient and Observer Scar Assessment Scale.
  
  
  RESULTS
  All patients successfully underwent lip reconstruction with the musculocutaneous nasolabial flap. There were no flap failures. Electromyographic activity was detected in 10 out of the 14 flaps tested. Oral competencies were well preserved and there were no cases of microstomia. Aesthetic results were also good.
  
  
  CONCLUSIONS
  The nasolabial flap for one-stage reconstruction of lip defects following lip resection is feasible. Good functional and aesthetic outcome can be achieved.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ngian-Chye
authors.initials: NC
authors.lastname: Tan
authors.forename: Ching-Hua
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Francesco M G
authors.initials: FM
authors.lastname: Riva
authors.forename: Seng-Feng
authors.initials: SF
authors.lastname: Jeng
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing / Q000502:physiology