Even though not supplying the same quantity of tissue as the frontal, deltopectoral and cervical flaps, the nasolabial flap is an excelent option for the correction of defects of small to moderate extension because of its spread, tissue composition and safety in relation to its blood nutrition. The present study tries to demonstrate the surgical technique used and the results obtained in seventeen nasolabial musculocutaneous submandibular island flaps used for mouth floor reconstruction after exeresis of malign tumors of the lower floor, in the period from December 1990 to July 1995, in the Service of Surgery of Head and Neck of Erasto Gaertner Hospital, in Curitiba. The basic objectives were to reconstruct the continuity of the buccal mucous membrane and preserve the mobility of the tongue (anterior 1/3) to the maximum. Only one out of the seventeen surgery cases is female and the predominant age range is within the sixties. The first surgery occurred in December 1990. One patient presented Zubrod II and the others Zubrod I. As to staging, there were 9 T2 cases, 5 T3 and 3 T4, 12 N0, 4 N2A and 1 N3. In relation to the histological type, one case of fibrosarcoma and sixteen cases of spinous cellular carcinoma were verified. One of the cases developed with total necrosis and another with partial necrosis, due to irrigation and draining respectively. In seven cases hair growth (beard) occurred because of the lower prolongament of the flap. The cases with infection (six) were due to necrosis of flap (two), cervical lymphadenectomy (two) and proximity of tracheostomy. In none of the cases cervical fistula was present. The main conclusions taken from the acquired experience after seventeen confectionated flaps are (a) that the surgical performance of the technique is the domain of the surgeon of head and neck, (b) that the viability of the flap, considering the occurrence of necrosis in it, was of 88.3%, (c) that the incidence of orocutaneous fistula was null, despite the presence of necrosis and infection in some cases, and (d) that the mobility of the tongue and the capacity to articulate oral phonemes comes close to normal, mainly if the primary tumor affects basically the mouth floor.
Bucal neoplasm; Mouth floor; Reconstruction; Surgical flap