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Odontogenic fibroma is a benign ectomesenchymal tumor classified as central and peripheral on the basis of its location and as an epithelium rich or epithelium poor based on its histological features. Radiological findings consist of radiolucent areas with well-defined bony margins. The lesion is detected early because of its location and usually treated with surgical excision and curettage. We present a case of giant odontogenic fibroma of right maxilla presenting as gross facial deformity and posing a dual challenge of excising the tumor mass and reconstructing the ensuing defect.

BackgroundTo evaluate the versatility and reach of modified nasolabial flap used in reconstruction of defects created in and around the oral cavity.MethodsA total number of 20 cases were selected. Out of which 13 were males and 7 females. The age of these patients ranged from 24–63 years. 29 modified nasolabial flaps were raised in twenty patients. Based on clinical and histopathological examination, out of 20 patients, 14 patients were diagnosed with oral submucous fibrosis, 3 with verrucous carcinoma, 1 with squamous papilloma, 1 with oro-antral fistula and 1 with traumatic loss of lower lip.ResultsMinimum preoperative interincisal distance (IID) was 0 mm and maximum was 15 mm with mean of 6.00±4.76 mm in patients with oral submucous fibrosis and 12 months postoperatively minimum IID was 16 mm and maximum was 41 mm with mean of 28.00±8.96 mm. In one case, dehiscence (3.4%) was noted on the anterior tip for which tip revision was done. Bulky appearance of the flap intraorally was observed in 2 cases (6.9%). Five (17.2%) among the 29 flaps had visible scar at the donor site postoperatively up to 3 months.ConclusionNumerous reconstructive techniques have been employed in the reconstruction of small to intermediate sized defects of oral cavity. Modified nasolabial flap is a versatile flap which has robust vascularity and can be successfully used with minimal complications. It can be rotated intraorally to extend from the soft palate to the lip. Thus, it can be used efficiently to treat the small defects of the oral cavity as well as recreating lost lip structure.

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