Frontal axial pattern flap combined with hard palate mucosa transplant in the reconstruction of midfacial defects after the excision of huge basal cell carcinoma

Abstract

BackgroundOur article describes our experience with using a frontal axial pattern flap combined with hard palate mucosa transplant to reconstruct midfacial defects after the excision of huge basal cell carcinoma.MethodsWe retrospectively reviewed four patients diagnosed with midface huge basal cell carcinoma through biopsy between 2014 and 2016. Both the eyelid and nose were involved in all the patients. All the patients underwent the studied surgical method and were followed up from 12 to 36 months.ResultsAll the patients preserved good eyelid function and relatively good esthetic satisfaction. No basal cell carcinoma recurred.ConclusionsThis combined surgical procedure is a good method for reconstructing defects after the excision of huge basal cell carcinomas in the midface.

Posterior lamella substitutes in full-thickness eyelid reconstruction: a narrative review

“…Their results showed that the three-layer structure is an effective procedure with satisfactory longterm results for reconstructing giant full-thickness defects in the lower eyelid with a mean follow-up period of 15 months (range, 6-24 months). Furthermore, in combination with frontal axial pattern flap, hard palatal mucosa transplant has been reported to reconstruct midfacial defects in four patients after the excision of giant basal cell carcinoma involving both the eyelid and nose (34). All the patients preserved well functional and cosmetic results despite the small sample size.…”

Surgical Strategies for Eyelid Defect Reconstruction: A Review on Principles and Techniques

“…The FBSTA-based frontal flap is similar to the Fricke flap but vascularized by a perforator of the FBSTA, which allows a significant supply of cutaneous tissue for covering defects of the upper or lower eyelid and the lateral canthal area [ 37 , 38 ]. This flap can be dissected into an island flap based on a perforator [ 38 , 39 ], which allows elevation of a thin flap for eyelid reconstruction within a single surgery.…”

“…The basic formula for this technique is one vascularized flap for anterior lamellar reconstruction in combination with one free graft for posterior lamellar replacement. The commonly used flaps are medially or laterally based orbicular myocutaneous flaps [ 98 , 99 ] and frontal or forehead axial flaps [ 37 , 100 ], and the commonly used posterior lamellar substitutes are HPM [ 37 , 58 ], auricular cartilage [ 100 ], tarsal grafts [ 99 ], and acellular dermal matrixes (ADMs) [ 82 ]. In contrast, a vascularized flap for posterior lamellar reconstruction and a free autograft for anterior reconstruction have also been used in full-thickness defect reconstruction [ 101 ].…”