Reconstruction after extended orbital exenteration using a fronto-lateral flap

Rodrigues, Marcelo Tadday; Köhler, Hugo Fontan; Faria, José Carlos Marques de; Ikeda, Mauro Kasuo; Vartanian, José Guilherme; Kowalski, Luiz Paulo

doi:10.1016/j.ijom.2009.03.709

Cited by 22 publications

(16 citation statements)

References 15 publications

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“…This procedure involves removal of the eye together with other orbital contents within the bony socket. 13 Although increased collaboration among different departments, progressive treatment planning, and consideration of reconstructive options that can cover almost all types and sizes of defects have enabled surgeons to perform adequate resection with no hesitation, patients with advanced SCC still have a 5-year survival rate of less than 50%. 7 The orbital exenteration procedure results in significant morbidity in the face, which negatively affects the patient's social life.…”

mentioning

confidence: 99%

Management of Neglected Periorbital Squamous Cell Carcinoma Requiring Orbital Exenteration

Karabekmez

Selimoglu²,

Duymaz³

et al. 2014

Journal of Craniofacial Surgery

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With its perineural invasion capacity, periorbital squamous cell carcinoma (SCC) may easily invade orbital structures. When SCC invades the orbital musculature or the orbit itself, orbital exenteration, one of the most disfiguring operations on the face, is required. We reviewed elderly patients with periorbitally localized SCC requiring orbital exenteration to evaluate reconstructive options and survival. A chart review of patients' records was conducted to identify all patients older than 65 years with periorbital malignancy requiring orbital exenteration from 2006 to 2011. A total of 9 patients who met the criteria were included in the study. The mean age at surgery was 77 ± 6.7 years, and the mean defect size was 74.2 cm2. All patients had a similar history of late presentation to a doctor because of hesitation to undergo surgery. The temporoparietal fascia flap, galeal flap, free gracilis flap, and free vastus lateralis musculocutaneous flap were the treatment options for reconstruction of the defects. All patients died during follow-up, and the mean survival was 15.7 months (range, 6-36 months). Only 2 of them had relapse before the death. Our small series suggest that elderly patients with periorbital SCC requiring orbital exenteration may not have enough survival to relapse because of the death from different causes without relapse or any sign of spreading cancer. Also, prolonged surgery with free flap reconstruction may increase the risk of postoperative intensive care unit requirement. Because local flaps may work very well for reconstructing the orbital exenteration defects, free flap option should be kept for selected cases.

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mentioning

confidence: 99%

Management of Neglected Periorbital Squamous Cell Carcinoma Requiring Orbital Exenteration

Karabekmez

Selimoglu²,

Duymaz³

et al. 2014

Journal of Craniofacial Surgery

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“…It has been used for reconstruction of isolated upper eyelid defects (2-4) such as for the anterior lamella in combination with a mucochondrial autologous graft taken from the alae (2) or in combination with skin grafting (4). It provides well-vascularized tissue for coverage of surface defects and orbital reconstruction after extended maxilelctomy (5,10) for total defects following orbital exenteration (6,9,10,12) without resection of the lateral orbital rim (7) or in combination with a glabellar flap (11).…”

Section: Discussionmentioning

confidence: 99%

The Temporalis Muscle Flap: A Useful Adjunct in Reconstruction of Combined Defects of the Upper and Lower Eyelids

Haykal

Antonyshyn

Gill

2015

Plastic Surgery Case Studies

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R econstruction of complex eyelid defects presents a challenge. Composite defects that involve both the upper and the lower eyelid, or that extend deeply to involve the lateral canthus and the bony orbit, are particularly difficult to repair. Under these circumstances, the temporalis muscle flap provides vascularized tissue, which can be used in restoring structural support to the lid complex.The temporalis region provides several regional flaps. The temporalis muscle is a type III (Mathes and Nahai classification) fan-shaped muscle with its origin in the temporal fossa. It receives its blood supply from the anterior and posterior deep temporal arteries, which are branches of the internal maxillary artery. These course between the muscle and the periosteum, allowing for subperiosteal elevation. Resection of the zygomatic arch and the coronoid process of the mandible (1) can increase its reach. The presence of two independent vascular territories enables separate use of the temporalis fascia or muscle in the elevation of regional flaps, making it very versatile in head and neck reconstruction (1). It has been described for isolated upper eyelid defects (2-4) and orbital reconstruction (5-12). BACKGrounD: Eyelid reconstruction following oncological resection remains a challenge. Multiple techniques have been described for isolated upper or lower eyelid defects. oBJECTIvE: To describe the use of the temporalis flap for reconstruction of an eyelid defect involving both the upper and lower eyelids. METHoDs: Excision of a basal cell carcinoma was performed. This resulted in full-thickness defects of the upper and lower eyelids, the lateral canthus including upper and lower canthal tendons, the upper right midface, temple, lateral two-thirds of the eyebrow and forehead. The tumour was found to be adherent to bone and dissecting deeply into the lateral orbital cavity as well as along the orbital roof. rEsuLTs: The lateral orbital rim was reconstructed using the pre-bent titanium mesh implant. A temporalis muscle flap allowed for draping over the reconstructed orbital rim and to provide reconstruction of the tarsal plates of the upper and lower eyelids. The remaining large cutaneous defect, which involved more than half of the lower eyelid, was reconstructed using a large Mustarde cervical facial rotation flap. ConCLusIons: The temporalis muscle flap provides abundant well vascularized tissue and has been described for head and neck reconstruction. A novel technique allows reconstruction of both the upper and lower eyelids using the temporalis muscle in combination with local flaps.

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“…4) cm. The external diameter of the supraobital artery at the place where it goes out of the orbital cav ity is 1.4±0.1 (1.3-1.5) mm [3] . After that, the artery will pass the supraorbital marg in and run to the fronto-partial.…”

Section: Applied Anatomy Of Supraobital Arteries Veins and Nervesmentioning

confidence: 94%

Repair of Nasal Soft Tissue Defects with Paramedian Forehead Skin Flap with Base at the Supraorbital Artery Region

Liang¹,

Han²,

Jiang³

et al. 2017

BIO Web Conf.

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Abstract. Purpose: T his study is used to explore the method for repairing nasal soft tissue defects with paramedian forehead skin flap with base at the supraorbital artery region and its curative effect. Method: Retrospective case study. Clinical data of one case of a patient with defects of most nasal soft tissue in China-Japan Union Hospital of Jilin University were used. T he forehead flap with base at the supraobital artery will be transferred to nasal soft tissue defects so as to repair the nose of the patient. Result: All forehead flaps with the blood supplied by supraobital artery of one patient case all survived. T he blood supply of the flap is stable because quality, color and luster are all similar with those of the nose. No bleeding, flap hypertrophy or overstaffed pedicle appeared after the operation. They all healed up in Phase I. Conclusion: Paramedian forehead skin flap with base at the supraorbital artery region is an ideal flap supply for repairing most nasal soft tissue defects. InstructionNose, which is in the center of our face, plays many important functions, such as breathing, smelling and beauty. The damage of nasal defects not only includes the loss of nasal functions but also some immense psychological trau ma. Thus, the functional recovery and reconstructive beauty appearance are main aims of nasal repairing reconstructive surgery. When repairing nasal soft tissue defects, doctors shall consider both the color and thickness of the flaps. The typical patient with serious nasal defects in our department is the one experiencing the resection of external nasal malignant tumors. We used paramedian forehead skin flaps with base at the supraorbital artery region fo r the repairing and reconstruction of his nose and we obtained relatively satisfactory results.

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Reconstruction after extended orbital exenteration using a fronto-lateral flap

Cited by 22 publications

References 15 publications

Management of Neglected Periorbital Squamous Cell Carcinoma Requiring Orbital Exenteration

Management of Neglected Periorbital Squamous Cell Carcinoma Requiring Orbital Exenteration

The Temporalis Muscle Flap: A Useful Adjunct in Reconstruction of Combined Defects of the Upper and Lower Eyelids

Repair of Nasal Soft Tissue Defects with Paramedian Forehead Skin Flap with Base at the Supraorbital Artery Region

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