Partial Maxillectomy Using a Novel Nasolabial Surgical Approach with Simultaneous Nasolabial Flap Reconstruction of the Maxillary Defect: Our Surgical Experience of 10 Cases

Abstract

Maxillary palatal defects due to tumor resection require immediate reconstruction to prevent morphological/functional disorders. Reconstruction options ranges from obturator placement to free flap. We adopted a surgical maxillary exposure using nasolabial groove incision in contrast to classical Weber Ferguson incision. This has the added advantage of simultaneous reconstruction of the resultant defect using nasolabial flap, with a good cosmetic and functional outcomes. We hereby present our experience in ten cases with palatal defects post maxillectomy for carcinoma of the upper gingivobuccal sulcus and upper alveolus reconstructed with this technique. This is a case series of ten patients (7 males and 3 females) who underwent partial maxillectomy using nasolabial groove incision with simultaneous reconstruction of palatal defect with nasolabial flap from January 2019 to June 2021 in our department. The primary disease was squamous cell carcinoma (SCC) in all ten patients with clinically N0 and M0. No necrosis, infection, or severe scar contracture in grafts was found in any patient. The wound stabilized, ingestion was started, and rehabilitation was performed with appropriate denture within 10 days after surgery in these patients. The postoperative oronasal communication (5×5 mm in size) in the posterior midline end was found in two cases, seen 1 month after surgery. All patients have good extra oral cosmetic outcomes. No radiation therapy was given in any case. This is a feasible surgical option utilizing nasolabial groove incision for partial maxillectomy along with simultaneous reconstruction of the resultant defect using nasolabial flap. It is a simple surgical procedure with reduced operative time with good cosmesis.