Variations on the rostral labial pivot flap for reconstruction of maxillary lip defects in four dogs.

The rostral labial pivot flap and its variants offer adaptable, low-morbidity reconstruction of rostral lip and paranasal defects in dogs.

This case series describes the application of the rostral labial pivot flap and its variants for reconstruction of rostral lip and paranasal defects in four dogs following tumor resection. The defects involved concurrent nasal mucosal involvement, requiring adaptable reconstructive techniques. Modifications to the standard rostral labial pivot flap included incorporation of a mucosal island flap for nasal mucosal reconstruction and a nasal rotation flap to reduce tension and address lip height discrepancy. All four dogs achieved acceptable cosmetic and functional outcomes with normal quality of life at follow-up. Minor complications occurred in two dogs: one developed an oronasal fistula and another experienced mild narial stenosis; notably, neither complication produced clinical signs. The technique demonstrated versatility in addressing complex three-dimensional defects involving the lip, paranasal region, and nasal mucosa simultaneously. The rostral labial pivot flap leverages local tissue with good color and texture match, minimizing donor site morbidity. Limitations of this study include the small sample size inherent to a short case series, which precludes definitive conclusions regarding success rates and complication frequencies. Nevertheless, the results support the rostral labial pivot flap as a reasonable reconstructive option for surgeons managing rostral maxillary defects in dogs. Larger prospective studies are needed to better characterize long-term outcomes, refine patient selection criteria, and establish standardized technique guidelines.

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