Rectus Abdominis Myocutaneous Free-Flap Reconstruction Following a Cranio-Orbital-Maxillary Resection for Neurofibrosarcoma

Chicarilli, Zeno N.; Davey, Lycurgus M.

doi:10.1097/00006534-198711000-00015

Cited by 29 publications

(22 citation statements)

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“…Microvascular free flaps [3,10,11,47] have also been recommended to cover defects following full resection of the eyelids. Facial or temporal vessels may be suitable for microvascular anastomoses.…”

Section: Discussionmentioning

confidence: 99%

Orbital exenteration: Surgical and reconstructive strategies

Mohr

Esser

1997

Graefe's Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Orbital exenteration: Surgical and reconstructive strategies

Mohr

Esser

1997

Graefe's Arch Clin Exp Ophthalmol

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“…1,2 In contrast, the pectoralis pedicle does not always reach the orbit easily, it may be associated with excessive bulk in the neck, and the donor site deformity can be remarkable. In addition, these pedicle flaps may not fill the orbit sufficiently to assist in the sealing of cerebrospinal fluid leaks, whereas the rectus abdominis free flap has been used effectively in this situation.…”

Section: Commentmentioning

confidence: 99%

“…Unfortunately, transposition of these flaps on their native short vascular pedicles results in a restricted arc of rotation and limits the volume of tissue effectively transferred to the orbit. 1,2 Reconstructive limitations imposed by the transposition of flaps tethered by their native vascular pedicle have been largely addressed with novel advances in microsurgery. A well-planned, singlestage free microvascular flap transfer can yield an aesthetically pleasing reconstruction with well-vascularized tissue of desired composition and volume.…”

mentioning

confidence: 99%

“…The rectus abdominis free flap has been used for many purposes, including repair of large head and neck defects as well as skull base cerebrospinal fluid leaks. [1][2][3][4][5][6][7][8][9][10] Costochondral cartilage may be included in rectus abdominis free flaps as a supplement for bone loss. 10 No report of this technique exists in the ophthalmic literature, and many ophthalmologists are unaware of this approach as a surgical option in both adults and children requiring exenteration.…”

mentioning

confidence: 99%

“…10 No report of this technique exists in the ophthalmic literature, and many ophthalmologists are unaware of this approach as a surgical option in both adults and children requiring exenteration. 1,2,[5][6][7][8][9][10] In this article, we present a technique for orbital reconstruction after exenteration by means of the rectus abdominis free flap in 2 children, 3 and 8 years of age.…”

mentioning

confidence: 99%

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Reconstruction With Rectus Abdominis Myocutaneous Free Flap After Orbital Exenteration in Children

Uusitalo

Ibarra²,

Fulton³

et al. 2001

Arch Ophthalmol

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To present a 1-stage technique for orbital reconstruction after exenteration with the use of myocutaneous rectus abdominis free flap in children.Surgical Technique: After orbital exenteration, a myocutaneous rectus abdominis free flap with long vascular pedicle is harvested from the abdomen. The flap is transferred to the orbit and the vascular pedicle is passed through an opening made in the lateral orbital wall, where it is anastomosed to superficial temporal vessels. The skin of the flap is trimmed to correspond to the eyelid defect and the incisions are closed.Methods: After informed consent was obtained, 2 children, 3 and 8 years old, underwent orbital reconstruction with a rectus abdominis free flap after exenteration for orbital rhabdomyosarcoma and orbital osteosarcoma in the setting of retinoblastoma.Results: This technique allowed easy postoperative wound care. Viability of the flap was excellent. The technique provided sufficient volume to fill the orbit, with improved aesthetic results and minimal donor site deformity. Conclusions:The postoperative care and aesthetic outcome in patients with rectus abdominis free flap after exenteration are much improved over those provided with traditional surgical techniques. This primary reconstruction is recommended for any patient requiring orbital exenteration, but particularly for pediatric patients who tolerate debridement of traditional exenteration sites poorly.

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