Efficacy of superiorly based nasolabial flap in post-mucor infrastructure maxillectomy defects

Reconstruction of post-mucor oral cavity defects (ranging from simple alveolectomy defects to complete maxillectomy defects) will improve the function, esthetics, and general health of an individual. Various surgical and prosthetic options are available for the successful reconstruction of the defects. The nasolabial flap has versatile role in the reconstruction of oral cavity defects because of its proximity to the defect area, optimal esthetic results, and less surgical morbidity unlike distant flaps. In this study, we assessed the efficiency of the nasolabial flap in reconstruction of post-mucor infrastructure maxillectomy defects in 42 individuals by comparing the pre-surgical and post-surgical abilities to speak and swallow.

Patients with post-mucor infrastructure maxillectomy defects were involved in this prospective study. Fifty-one patients who met the inclusion criteria were selected. All the study parameters (swallowing ability, hypernasality, speech intelligibility, and subjective satisfaction of an individual) were assessed preoperatively. Reconstruction of the defect was done with a superiorly based nasolabial flap. Nine patients were lost to follow up, and 42 patients were followed up for six months to evaluate the study parameters.

Pre-surgical and post-surgical statistical data analysis shows that there is a significant improvement in the functional outcomes of an individual. 76% of the patients showed no signs of nasal regurgitation, dribbling of saliva, or coughing upon swallowing after reconstruction of the defect with nasolabial flap. Significant improvement in speech after the closure of maxillary defect was observed as 93% of patients had socially acceptable speech and 64.5% had normal intelligible speech postoperatively. Upon subjective satisfaction assessment, 64% of the patients were satisfied with the treatment procedure.

Closure of oro-antral communication and creation of a seal between oral and nasal cavities using the nasolabial flap leads to improvement in the function of an individual in terms of speech intelligibility and swallowing ability. The nasolabial flap can be considered as an optimal option for managing post-mucor infrastructure maxillectomy defects by restoring functional and psychosocial well-being of a person.