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Introduction: Several flaps have been described for reconstructing facial or oral defects. Flaps such as forehead and pectoralis major are often too bulky for small-to-moderate-sized defects, for which nasolabial flaps are often ideal. However, nasolabial flaps have limited mobility and reach and may need two stages, particularly for intraoral defects. According to recent literatures, facial artery provides numerous small cutaneous perforators, based on which skin flaps can be islanded, with greater mobility and reach for reconstruction of small-to-moderate-sized intraoral and facial defects in one stage. Our study aims to evaluate the reliability and versatility of facial artery perforator-based flaps in the reconstruction of such defects. Materials and Methods: A ethical committee-approved retrospective study was conducted on data of the patients attending our outpatient department between February 2014 and October 2015 with small-to-moderate-sized facial/oral lesions. The total sample size was 23. We studied the relation of flap survival with size of flap, route of inset and neck dissection, functional and aesthetic outcomes and feasibility of adjuvant therapy in cases of malignancies. Results and Analysis: A wide range of facial defects, especially intraoral defects, could be reconstructed in one stage using facial artery perforator-based flaps. The flaps were reliable. Complications included only partial skin loss of the flaps in a few cases. Complications were directly related to the length of the flaps and the route of inset. Functional and aesthetic outcomes were satisfactory and none of the flaps showed any significant post-radiotherapy changes. Conclusions: We concluded that facial artery perforator flap can be a simple, safe, versatile and one-stage alternative to the traditional flaps in the reconstruction of small-to-moderate-sized facial defects. Neck dissection can be safely done in the same sitting.

Introduction: Several flaps have been described for reconstructing facial or oral defects. Flaps such as forehead and pectoralis major are often too bulky for small-to-moderate-sized defects, for which nasolabial flaps are often ideal. However, nasolabial flaps have limited mobility and reach and may need two stages, particularly for intraoral defects. According to recent literatures, facial artery provides numerous small cutaneous perforators, based on which skin flaps can be islanded, with greater mobility and reach for reconstruction of small-to-moderate-sized intraoral and facial defects in one stage. Our study aims to evaluate the reliability and versatility of facial artery perforator-based flaps in the reconstruction of such defects. Materials and Methods: A ethical committee-approved retrospective study was conducted on data of the patients attending our outpatient department between February 2014 and October 2015 with small-to-moderate-sized facial/oral lesions. The total sample size was 23. We studied the relation of flap survival with size of flap, route of inset and neck dissection, functional and aesthetic outcomes and feasibility of adjuvant therapy in cases of malignancies. Results and Analysis: A wide range of facial defects, especially intraoral defects, could be reconstructed in one stage using facial artery perforator-based flaps. The flaps were reliable. Complications included only partial skin loss of the flaps in a few cases. Complications were directly related to the length of the flaps and the route of inset. Functional and aesthetic outcomes were satisfactory and none of the flaps showed any significant post-radiotherapy changes. Conclusions: We concluded that facial artery perforator flap can be a simple, safe, versatile and one-stage alternative to the traditional flaps in the reconstruction of small-to-moderate-sized facial defects. Neck dissection can be safely done in the same sitting. [ABSTRACT FROM AUTHOR]

a nine-year-old xeroderma pigmentosa (xp) child presented with a non-healing ulcer on the right side of the lower lip. on histological examination the lesion proved to be squamous cell carcinoma. wide excision was done. the excision included lip, buccal mucosa with mucocutaneous junction and only the upper portion of the orbicularis oris muscle. the lip was reconstructed with superiorly based nasolabial flap. recently, his younger brother, who is also suffering from xp developed squamous cell carcinoma of lower lip, and presented to us. wide excision of the lesion was done. the defect was closed primarily. the patient and his brother both have been advised to protect themselves from uv radiation. both are being kept under intense surveillance. ten months of follow-up of the elder brother showed satisfactory, good-looking lip with no sign of recurrence at the local site or at the neck.

A nine-year-old xeroderma pigmentosa (XP) child presented with a non-healing ulcer on the right side of the lower lip. On histological examination the lesion proved to be squamous cell carcinoma. Wide excision was done. The excision included lip, buccal mucosa with mucocutaneous junction and only the upper portion of the orbicularis oris muscle. The lip was reconstructed with superiorly based nasolabial flap. Recently, his younger brother, who is also suffering from XP developed squamous cell carcinoma of lower lip, and presented to us. Wide excision of the lesion was done. The defect was closed primarily. The patient and his brother both have been advised to protect themselves from UV radiation. Both are being kept under intense surveillance. Ten months of follow-up of the elder brother showed satisfactory, good-looking lip with no sign of recurrence at the local site or at the neck.