Clinical outcomes of island nasolabial flap reconstruction for oral cavity defects: a prospective case series from a tertiary cancer center in Nepal

Abstract Background Reconstruction of oral cavity defects following tumor resection remains a major surgical challenge, particularly in resource-limited settings. Although microvascular free flaps are considered the gold standard for large defects, they require advanced expertise, prolonged operative time, and specialized infrastructure. The Island Nasolabial Flap (INLF) represents a reliable locoregional alternative with reduced operative complexity. This study aimed to evaluate the clinical outcomes and complication profile of INLF reconstruction for oral cavity defects at a tertiary cancer center in Nepal. Methods A prospective descriptive case series was conducted over a six-month period (January 2025 to June 2025) at the ENT and Head–Neck Unit of Tertiary cancer center in Nepal. All patients undergoing oral cavity tumor resection followed by INLF reconstruction during the study period were included. Demographic details, tumor staging, flap size and side, and postoperative complications (infection, orocutaneous fistula, wound dehiscence, flap necrosis, and bulky appearance) were recorded using a structured proforma. Outcomes were analyzed using descriptive statistics. Results Thirty-four patients underwent Island Nasolabial Flap reconstruction during the study period. The majority were male, with a mean age in the middle-aged to elderly group. Most tumors were locally advanced at presentation (TNM stage III–IV). Flap sizes varied depending on defect dimensions and anatomical location. Overall flap survival rate was 100%. Among postoperative complications, hematoma was seen only in 5.9% of cases. No cases of flap necrosis, wound dehiscence, surgical site infection, or orocutaneous fistula were observed. No cases required conversion to free flap reconstruction. Routine postoperative assessment suggested acceptable functional recovery and aesthetic outcome. Conclusion Island Nasolabial Flap is a safe, reliable, and cost-effective option for reconstruction of selected oral cavity defects in resource-limited settings. It offers high flap survival with minimal complications and represents a practical alternative to microvascular free flaps.