Two-step strategy—conjunctival flap covering surgery combined with secondary deep anterior lamellar keratoplasty for the treatment of high-risk fungal keratitis

AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.

Influence of Flap Parameters on the Aerodynamic Performance of a Wind-Turbine Airfoil

A numerical method has been used to analyze the flow field related to a NACA 0015 airfoil with and without a flap and assess the influence of the flap height and angle on the surface pressure coefficient,lift coefficient,and drag coefficient.The numerical results demonstrate that the flap can effectively improve the lift coefficient of the airfoil;however,at small attack angles,its influence is significantly reduced.When the angle of attack exceeds the critical stall angle and the flap height is 1.5%of the chord length,the influence of the flap becomes very evident.As the flap height increases,the starting point of the separation vortex gradually moves forward and generates a larger wake vortex.Optimal aerodynamic characteristics are obtained for 1.5%(of the chord length)flap height and a 45°flap angle;in this case,the separation vortex is effectively reduced.

Pedicled abdominal flap using deep inferior epigastric artery perforators for forearm reconstruction: A case report

BACKGROUND Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue defects.However,some drawbacks include restricted flap size,partial flap loss,and donor-site morbidity.To address these concerns,we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators(DIEP)for forearm reconstruction in a patient with a large soft tissue defect.CASE SUMMARY A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine.A 15 cm×10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was found.One week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique,the patient was referred to the plastic and recon-structive surgery department for wound coverage.Surgical debridement and negative-pressure wound therapy revealed a 20 cm×15 cm soft tissue defect.A pedicle abdominal flap with the DIEP was used to cover the defect.Three weeks later,the flap was detached from the abdomen,and the abdominal defect was directly closed.Subsequently,the second stage of Masquelet technique was performed at the fracture site at week 10.Finally,all donor and recipient sites healed without complications,such as flap dehiscence,infection,hematoma,or necrosis.Fracture site osteosynthesis was achieved without complications.CONCLUSION Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.

Management of Square Carcinoma of the Lower Lip Using Camille-Bernard Flap under Local Anesthesia: When Constraints Dictate Our Attitude

Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.

Sternocleidomastoid flap for reconstruction of tongue small cell carcinoma: A case report

BACKGROUND The management of tongue carcinoma is excision and radical neck dissection followed with reconstruction.This is a case report of a patient with tongue squamous cell carcinoma(SCC)who underwent the procedure with sternocleidomastoid(SCM)flap reconstruction.CASE SUMMARY A 52-year-old woman without smoking history complained tongue ulcer since 3 years ago.Based on the histopathological examination,the patient was diagnosed with T2N2M0 right tongue SCC and underwent wide excision of tumor;right mandibular;neck dissection and were reconstructed with SCM flap.CONCLUSION SCC of the tongue requires wide excision and dissection of the neck and mandible if infiltration into the surrounding lymph nodes has been found.The SCM flap reconstruction could be used post-surgery.

Investigating the Prospect of Rooftop Flapping Wind Turbine in Bangladesh

The objective of this research is mainly focused on environment-friendly and moderately slow flapping wind turbine which can easily operate in or near urban areas or rooftops owing to scale merit with low-frequency turbine noise, installation cost, avian mortality rate and safety consideration etc. We considered lift and drag based slow flapping type wind turbine to operate in the residential arena. In order to study the flapping wind turbine performance, we collect ten years of wind velocity records from the Bangladesh Meteorological Department for two different stations in Bangladesh. The velocity contours and profiles have been the points of observation to find out the suitable turbine shape having the efficiency to initiate the turbine rotation. We made a simple comparative study of the wind velocities profile obtained from the different stations in Bangladesh. A simple numerical study has been conducted and presented by graphical analysis to inspect the wind flow above the constructed structure. Finally, we analyze the wind velocity for the individual months and determine the turbine performance in terms of torque for the average wind velocities of Dhaka and Cox’s Bazar stations.

A combined therapy for the repair of alar defects that consists of a modified spiral flap and postoperative nasal stent

Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.

Current evidence on the use of near-infrared spectroscopy for postoperative free flap monitoring: A systematic review

Background: Although the surgical outcomes of free flap reconstruction have improved over time, vascular compromise remains a devastating complication. Near-infrared spectroscopy(NIRS) is a promising new free flap monitoring technique with the potential for better outcomes than clinical monitoring(CM). This systematic review aims to provide a comprehensive review of the current evidence regarding the use of NIRS for free flap monitoring.Methods: A systematic literature review was performed, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, on existing NRIS studies, including the clinical outcomes of NIRS monitoring, speed of detection, diagnostic accuracy, variables affecting NIRS accuracy, and cost-effectiveness.Results: A total of 24 articles were included in this analysis. In most instances of flap compromise, NIRS enabled earlier detection of compromise than did CM, by an average of 8.1(0.5±32.0) h. The flap salvage rate of flaps monitored with CM and NIRS(87.2%) was significantly higher than that of flaps monitored with CM alone(50.0%)(P<0.01). The overall survival rate for flaps monitored with CM and NIRS(98.1%) was also significantly higher than that for flaps monitored with CM alone(96.3%)(P=0.02). Blood oxygen saturation was the only variable with a significant effect on NIRS results.Conclusion: NIRS is an objective and reliable flap monitoring technique that provides superior flap salvage and survival rates compared with CM, which translates to cost savings and a reduction in workload for healthcare staff. Further large-scale studies are needed to standardize flap compromise criterion values and efficacy for different flap types.

Salvage anastomosis in free PAP-flap breast reconstruction:What about free flap neovascularization?

Since the emergence of microsurgery in reconstructive surgery, free flaps have become a key tool in the management of patients with breast cancer. One such flap is the profunda artery perforator(PAP) flap. To date,there is no scientific consensus on whether voluminous free flaps remain dependent on their vascular pedicle throughout their lifespan. Therefore, the pedicle should always be carefully protected during revision surgery.In this article, we review the case of a middle-aged woman who suffered a pedicle transection needing reanastomosis during revision surgery six months after free-flap breast reconstruction. A 52-year-old woman who noticed a firm nodule in her right breast and armpit was referred to our department for surgical management. The Caucasian woman presented with no significant medical history or symptoms at the first consultation. Ultrasound-guided biopsy confirmed an invasive grade Ⅲ lobular carcinoma. Following staging,the patient underwent neoadjuvant chemotherapy before a right mastectomy with a complete homolateral axillary lymph node dissection and postoperative radiotherapy. One year after completing radiotherapy, free flap reconstruction with a PAP flap was performed, and six months later, revision surgery was required to enhance the volume of the reconstructed breast with a tissue expander and later an implant. Unfortunately,pedicle transection occurred during revision surgery, causing complete devascularization of the flap, which was confirmed by intraoperative Indocyanine Green imaging. The authors elected to perform salvage reanastomosis during the surgery. In keeping with the author’s 23-year experience with free flaps, the vascular pedicle should always be preserved in voluminous free flaps, as neovascularization alone may not ensure whole flap survival. The authors suggest always attempting re-anastomosis if vessels are compromised during revision surgery.

Preliminary study on the efficacy of lacrimal duct reconstruction with pedicled conjunctival flap in the treatment of severe lacrimal canalicular obstruction with conjunctivochalasis

AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This study was per formed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019.The clinical data included the degree of preoperative epiphora and postoperative relief,preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy,postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test,etc.Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.RESULTS:All 9 patients(9 eyes)had severe canalicular obstruction with conjunctivochalasis.The patients included 4 males and 5 females aged between 47–65y with an average age of 52.2±6.7y.At 3mo follow-up,the tube was removed and the patients were followed for a further 3mo.After tube removal,6 patients showed no epiphora.These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results.Two patientshad epiphora.Also,syringing showed partial patency of the reconstructed lacrimal duct.One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct.The total effective rate of the operation was 8/9,with no serious complications.CONCLUSION:Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.

Nasal sill reconstruction with the Abbe flap after skin cancer resection:A case report

Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis.

Subcutaneous pedicled propeller flap technique for microscopic reconstruction of eyelid defects

AIM:To describe the subcutaneous pedicled propeller flap technique for the microscopic reconstruction of eyelid defects and evaluate its outcomes.METHODS:The clinical data of 23 patients(23 eyes)who underwent microscopic reconstruction of eyelid defects with the subcutaneous pedicled propeller flap technique were retrospectively analyzed.All patients underwent eyelid tumor resection and one-stage microscopic reconstruction with the subcutaneous pedicled propeller flap for anterioror posterior-layer eyelid defects.The survival rate of the propeller flap,eyelid function and appearance,tumor recurrence rate,and patient satisfaction were evaluated after the surgery.RESULTS:The patients consisted of 12 men and 11 women,aged 31–82y(mean,58.9y).The longest followup time was 5y,and the shortest was 3mo.All the propeller flaps survived well.There was no significant difference in color and luster between the flap and adjacent tissues,and there was no dog ear phenomenon.No obvious scarring was observed.There were no obvious abnormalities of eyelid morphology or function,and no adverse complications such as exposure keratitis,entropion,ectropion,ptosis,and eyelid retraction.No tumor recurrence was found at the time of the last follow-up.All patients were satisfied with the surgical results.CONCLUSION:The subcutaneous pedicled propeller flap technique for the microscopic reconstruction of eyelid defects has satisfactor y outcomes in terms of eyelid function and esthetics,and merits clinical application.

“In situ bone flap” combined with vascular pedicled mucous flap to reconstruction of skull base defect

BACKGROUND At present,neuroendoscopy technology has made rapid development,and great progress has been made in the operation of lesions in the saddle area of the skull base.However,the complications of cerebrospinal fluid and intracranial infection after the operation are still important and life-threatening complications,which may lead to poor prognosis.AIM To investigate the method of in situ bone flap combined with nasal septum mucosal flap for reconstruction of enlarged skull base defect by endonasal sphenoidal approach and to discuss its application effect.METHODS Clinical data of 24 patients undergoing transnasal sphenoidal endoscopic approach in the Department of Neurosurgery,Affiliated 2 Hospital of Nantong University from January 2019 to December 2022 were retrospectively analyzed.All patients underwent multi-layer reconstruction of skull base using in situ bone flap combined with nasal septum mucosa flap.The incidence of intraoperative and postoperative cerebrospinal fluid leakage and intracranial infection were analyzed,and the application effect and technical key points of in situ bone flap combined with nasal septum mucosa flap for skull base bone reconstruction were analyzed.RESULTS There were 5 cases of high flow cerebrospinal fluid(CSF)leakage and 7 cases of low flow CSF leakage.Postoperative cerebrospinal fluid leakage occurred in 2 patients(8.3%)and intracranial infection in 2 patients(8.3%),which were cured after strict bed rest,continuous drainage of lumbar cistern combined with antibiotic treatment,and no secondary surgical repair was required.The patients were followed up for 8 to 36 months after the operation,and no delayed cerebrospinal fluid leakage or intracranial infection occurred during the follow-up.Computed tomography reconstruction of skull base showed satisfactory reconstruction after surgery.CONCLUSION The use of in situ bone flap combined with vascular pedicled mucous flap to reconstruction of skull base defect after endonasal sphenoidal approach under neuroendoscopy has a lower incidence of cerebrospinal fluid leakage and lower complications,which has certain advantages and is worthy of clinical promotion.

Supraclavicular artery island flap for reconstruction of hypopharynx and upper esophagus defects:A case report and literature review

We report a case of a 74-year-old female with hypopharyngeal cancer who developed a pharyngoesophageal fistula and neck skin defect after total laryngectomy.To reconstruct the hypopharynx,upper esophagus,and neck skin defect,we used a supraclavicular artery island flap(SCAIF)for one-stage reconstruction.SCAIF offered reliable blood supply,minimal donor site morbidity,and excellent cosmetic outcomes.Although a small portion of the flap developed necrosis,it healed without surgical intervention.We also conducted a literature review of previously published articles on SCAIF for head and neck reconstruction.Our review highlights the advantages and limitations of SCAIF as a promising option for one-stage reconstruction of complex hypopharyngeal and upper esophageal defects with neck skin defects in selected patients.This case report provides valuable insights into the use of SCAIF in complex head and neck reconstructions,which can help improve patient outcomes and quality of life.

Devastating complication of negative pressure wound therapy after deep inferior epigastric perforator free flap surgery:A case report

BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence.They require immediate and appropriate management before they progress to an irreversible condition.Although negative pressure wound therapy(NPWT)can prevent wound progression by increasing microcirculation,the inappropriate application of NPWT on complicationthreatened transferred and replanted tissues can induce an adverse effect.CASE SUMMARY A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap.While applying a heating pad directly to the flap site,she sustained a deep second to third-degree contact burn over 30%of the transferred flap on postoperative 7 d.As the necrotic changes had progressed,we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d.After 4 d of NPWT application,the exposed fatty tissues of the flap changed to dry and browncolored necrotic tissues.Upon further debridement,we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery.CONCLUSION Although NPWT has been shown to be successful for treating various wound types,the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.

Measurement of combined flap thickness for reconstruction of decubitus ulcer using computed tomography

BACKGROUND Various reconstruction options have been introduced to treat decubitus ulcers.A combined flap that takes advantage of the fasciocutaneous and muscle flaps has been proven to be effective in reconstructing decubitus ulcers in previous studies.However,no studies have measured combined flap thickness.This is the first study to demonstrate the superiority of the combined flap by measuring its thickness using enhanced abdominopelvic computed tomography(APCT).AIM To evaluate combined flap modality as a useful reconstruction option for decubitus ulcers using measurements obtained through APCT.METHODS Fifteen patients with paraplegia who underwent combined flap surgery for reconstruction of decubitus ulcers between March 2020 and December 2021 were included.The defects in the skin and muscle components were reconstructed separately.The inner gluteus muscle flap was split and manipulated to obliterate dead space.The outer fasciocutaneous flap was transposed to cover the muscle flap and opening of the decubitus ulcer.Subsequently,we performed enhanced APCT at 3 wk and 6 mo postoperatively to measure the flap thickness.RESULTS The mean flap thickness was 32.85±8.89 mm at 3 wk postoperatively and 29.27±8.22 mm at 6 mo postoperatively.The flap thickness was maintained without any major complications such as contour deformities or recurrence.CONCLUSION Although there was a significant decrease in flap thickness as measured by APCT,the combined flap provided sufficient padding and maintained its thickness even at 6 mo after reconstruction,suggesting that the combined flap modality may be a useful reconstruction option for patients with paraplegic decubitus ulcers.

Clinical observation of endoscopic skull base reconstruction with an anterolateral thigh free fascia flap

Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is the main treatment for radiation osteonecrosis.The repair after the operation is very important.Inappropriate repair or lack of repair can easily cause local infection that can even spread to the brain,aggravating osteonecrosis.This study aimed to verify the feasibility and safety of the ante-rolateral thigh free fascia flap in repairing large skull base defects.Methods:From June 2021 to July 2022,a total of 12 patients with a history of radiotherapy for naso-pharyngeal carcinoma received surgical treatment at the Department of Otolaryngology Head&Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.All patients were diagnosed with radiation osteonecrosis of the skull base with large skull base defects.During the endoscopic operation,a free anterolateral thigh fascia flap was used to repair the skull base and complete vascular anastomosis reconstruction.The preoperative and postoperative pain scores were retrospectively analyzed,and the dynamic changes in endoscopic surgery sites were observed.Results:The 12 patients had a median age of 58 y,with 8(66.7%)males and 4(33.3%)females.The median headache score for the patients was 5(4-7)before surgery.The patient's headache was significantly relieved postoperatively,with 11 patients having a score of 0 and one patient having a score of 1.The stench was completely resolved after the operation.There were no serious complications during the perioperative period or 12 months after the operation.Conclusion:The application of anterolateral thigh free fascia flap in skull base reconstruction is a safe and reliable reconstruction technique suitable for endoscopic surgical repair of large-scale skull base necrosis.

Does the advantage of transcutaneous oximetry measurements in diabetic foot ulcer apply equally to free flap reconstruction?

BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.

Application of a jigsaw puzzle flap based on free-style perforator to repair large scalp defects after tumor resection:A case series

Background:Reconstruction of large scalp defects after tumor resection is common and challenging.Free skin grafting or free flap transfer is always performed.However,these techniques can result in poor functional and cosmetic outcomes.Methods:In the Second Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Chengdu Medical College,35 patients underwent jigsaw puzzle flap procedures based on a free-style perforator to repair large scalp defects after tumor resection from May 2013 to November 2022.The key to this procedure was to divide a large defect into several smaller parts that correspond to adjacent free-style perforators around the scalp defect.The free-style perforator flaps were designed in different ways,such as propeller flaps,rotation flaps,and V-Y advancement flaps,which were pedicled with free-style perforators.All of the small flaps were then mobilized to the defect and sutured to each other to create a new,large jigsaw puzzle-like flap to cover the large scalp defect.Finally,all the donor sites were closed directly.Results:Overall,35 patients were treated.The average defect size was 72 cm^(2)(range,25-91 cm^(2)).All flaps had a satisfactory appearance after follow-up periods of 6 months-10 years.Local tumor recurrence occurred in one case.Conclusion:The application of a jigsaw puzzle flap based on a free-style perforator is a suitable option for the reconstruction of large scalp defects after resection,yielding satisfactory functional and cosmetic results.

Nasolabial perforator flap for nasal defects

Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and the perforator flap.However,the localization of perforators makes the clinical application of a nasolabial perforator flap difficult.This review aims to provide a comprehensive summary of the nasolabial perforator flap from anatomical,methodological,and clinical application aspects,intending to provide plastic surgeons with a reference on conducting nasal reconstruction with a nasolabial perforator flap.