“Pickaxe” Double Flap: A Useful “Tool” for Reconstruction of Deep Large Medial Canthal Defects—5-Year Experience and Brief Literature Review

Lykoudis, Efstathios G.; Lykoudis, George E.; Alexiou, George Α.

doi:10.1007/s00266-015-0462-3

Cited by 13 publications

(7 citation statements)

References 15 publications

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“…In these situations, a GF can result in a better cosmetic outcome than that obtained with a free skin graft. 20 , 21 In some cases, as described in the first patient, a GF alone was enough to successfully reconstruct the MCR as demonstrated by Meadows and Manners 18 or Turgut et al 17 In cases of larger medial canthal defects involving upper and lower eyelid, simultaneous use of two flaps 22 , 23 , 24 , 25 or a combination of three local flaps 26 , 27 , 28 has also been reported. The procedure used in the second patient included two flaps, a GF and a CLRF.…”

Section: Discussionmentioning

confidence: 92%

Utility of the Glabellar Flap in the Reconstruction of Medial Canthal Tumors after Mohs Surgery

Díaz-Céspedes¹,

Evangelio²,

Oprisan³

et al. 2021

tjo

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The goals of periorbital region reconstruction are to obtain both functional and esthetic results. Medial canthus is the second most common periorbital location for basal cell carcinoma. If left untreated, it is locally destructive but rarely metastasizes. Incompletely resected medial canthal tumors recur or penetrate along the lacrimal path and expand to wider lesions. A safety margin is necessary to ensure a complete lesion resection. Since it was introduced in 1941, Mohs surgery has been promoted as an efficient method of dealing with infiltrative periorbital skin tumors. It has been shown to have high rates of complete cancer removal during surgery, minimizing the amount of normal tissue loss and securing better functional and cosmetic outcomes. Due to its concave contour and convergence of skin units with variable thickness, texture and mobility, reconstruction of the medial canthal region (MCR) remains challenging. Reconstructive methods such as free full-thickness skin grafts and glabellar flaps have been used alone or in combination with other techniques. The concavity of the canthus must be achieved, but the maintenance of the normal contour and symmetry of the surrounding tissue is critical. The glabellar flap (GF) is a triangular advancement flap that adequately restores the volume in deeper defects, guaranteeing sufficient vascular support without complex or undesirable scars. We present two cases of basal cell carcinoma affecting the MCR that was successfully reconstructed using a GF alone in one case and together with a cheek advancement flap in the second one. In both cases, tumor excision was performed using Mohs surgery.

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Section: Discussionmentioning

confidence: 92%

Utility of the Glabellar Flap in the Reconstruction of Medial Canthal Tumors after Mohs Surgery

Díaz-Céspedes¹,

Evangelio²,

Oprisan³

et al. 2021

tjo

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“…The raised skin caused by the flap pedicle passing the dorsum of the nasal area was not apparent and showed significant enhancement in the flap mass at follow-ups, tolerable to the patients since it was explained to each patient prior to the surgery. Lykoudis 18 and Chao 19 demonstrated the employment of glabellar flap and observed it to be straightforward, dependable and aesthetically acceptable for reconstruction of medial canthus deficits.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Medial Canthal Tumor by Rotation Flap

Qurban

Kamil²,

Mahmood³

2020

pak J Ophthalmol

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Purpose: To describe the cosmetic outcome after repairing medial canthal defects via glabellar rotation flaps in patients undergoing wide clear margin excision of medial canthal tumour. Study Design: Interventional case series. Place and Duration of Study: This study was conducted at Khalid Eye Clinic, Nazimabad, Karachi, from March 2019 to August 2019. Methods: Study approval was obtained from the Ethical Review Committee. Eleven patients of both genders with clinically suspected medial canthal tumor were included in the study. Patients who underwent previous treatment such as radiation, cryotherapy or surgery were excluded. All surgeries were done to remove the tumor along with surrounding wide clear margins followed by reconstruction of the defect of the medial canthusareawith the help of arotation flap. Patients were followed for a period of up to six months post operatively for any wound related problems or recurrence. All patients were informed about the study and consent was obtained from each of them. Results: All eleven patients of this study were satisfied at the end of the follow-up period with the final cosmetic outcome. Seven out of elevenpatients were males and the remaining four were females, which also highlighted a greater incidence of medial canthal tumors in the male gender. Conclusion: Glabellar rotation flap is a suitable procedurefor themedial canthal area restoration after the tumor excision and can be customizedas per the characteristics of the surrounding skin as well as thesite, dimensions, and profundity of the defect. Key Words: Medial canthal tumor, Glabellar rotation flap, Medial canthus.

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“…Its deeply set location makes it a difficult area to reconstruct. Many techniques have been described to reconstruct the defects in this area, such as skin graft, 1 local/ loco-regional flaps, such as rhomboid flap, 2-7 glabellar flap, [5][6][7][8] bilobed flap, [9][10][11] myocutaneous VY advancement flap, 12 Pickaxe'' double flap, 13 forehead flap, and eyelid myocutaneous flap. 14 During the past three decades, 35 cases ofmedial canthal defects were reconstructed by local/loco-regional flaps.…”

Section: Referencesmentioning

confidence: 99%

Reconstruction of Medial Canthal Defects by Local/Loco-Regional Flaps

Bhandari

2021

Journal of Craniofacial Surgery

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“Pickaxe” Double Flap: A Useful “Tool” for Reconstruction of Deep Large Medial Canthal Defects—5-Year Experience and Brief Literature Review

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 13 publications

References 15 publications

Utility of the Glabellar Flap in the Reconstruction of Medial Canthal Tumors after Mohs Surgery

Utility of the Glabellar Flap in the Reconstruction of Medial Canthal Tumors after Mohs Surgery

Treatment of Medial Canthal Tumor by Rotation Flap

Reconstruction of Medial Canthal Defects by Local/Loco-Regional Flaps

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