Total Eyelid Reconstruction with Free Dorsalis Pedis Flap after Deep Facial Burn

Thai, Khang; Billmire, David A.; Yakuboff, Kevin P.

doi:10.1097/00006534-199909020-00024

Cited by 31 publications

(20 citation statements)

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“…5,7 Temporizing measures such as moisture chambers and scleral contact lenses can be used initially. 1,7,9,10 We believe that good visual outcome in this case was due to the early mobilization of remaining conjunctiva to completely cover the globe. This is a critical initial step in preserving vision until a more definitive surgery can be done at a later time.…”

Section: Case Reportmentioning

confidence: 69%

“…There are few cases in the literature of total eyelid loss with repair using free flaps. [1][2][3] To our knowledge, this is the first reported case of good visual outcome following reconstruction for total eyelid loss using a microvascular forearm free flap. Informed verbal consent for use of clinical information and informed written consent for use of clinical photographs were obtained.…”

mentioning

confidence: 77%

“…Thai et al 1 describes the use of a dorsalis pedis flap with nasal septal cartilage in a burn patient. Rubino et al 2 described a perforator anterolateral thigh flap with anastomosis to the superficial temporal vessels and a fascial strip for support.…”

Section: Discussionmentioning

confidence: 99%

“…5 Few cases of total eyelid loss have been described, 1-3,5-8 particularly with an intact globe and useful visual acuity. 1,[5][6][7][8] After eyelid loss, corneal protection is the immediate goal. 5,7 Temporizing measures such as moisture chambers and scleral contact lenses can be used initially.…”

Section: Case Reportmentioning

confidence: 99%

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Microvascular Free Flap for Total Eyelid Reconstruction With a Visually Useful Eye

Ghadiali

Patel

Levine

et al. 2016

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Total eyelid loss, full thickness loss of the upper and lower eyelids, is uncommon and surgically challenging. Eyelid reconstruction after such injuries can be further complicated by loss of adjacent tissue. When tissue for local flaps is unavailable, free flaps must be considered. Few cases of total eyelid reconstruction via microvascular free flap have been reported, especially with an intact globe and good visual acuity. In this report, we describe the use of a microvascular free flap based on the radial artery for total eyelid reconstruction in a patient with an intact globe and useful visual acuity.

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Section: Case Reportmentioning

confidence: 69%

mentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Microvascular Free Flap for Total Eyelid Reconstruction With a Visually Useful Eye

Ghadiali

Patel

Levine

et al. 2016

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Previous articles have described techniques for reconstruction of both the upper and lower eyelids using split-and full-thickness grafts (26,27), a pedicle deltopectoral flap (28), a paramedian forehead flap (29), a free dorsalis pedis flap (30,31), a spindle-shaped 'lateral orbital island flap' designed between the lateral canthus and the sideburn (19) or a free anterolateral thigh (ALT) flap (32). Each of these grafts or flaps were used to reconstruct both components.…”

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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Techniques and Outcomes of Total Upper and Lower Eyelid Reconstruction

deSousa

Leibovitch²,

Malhotra³

et al. 2007

Arch Ophthalmol

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Objectives: To describe techniques used for reconstruction of the eyelids following total loss of the upper and lower eyelids and to describe visual and functional outcomes. Methods: Multicenter, retrospective, interventional case series of all of the patients requiring unilateral reconstruction of both the upper and lower eyelids. Results: Six cases were identified, 1 following trauma and 5 following tumor excision (4 with basal cell carcinoma and 1 with melanoma). The median age was 69 years (range, 18-90 years). Primary repair using preserved tissue was carried out in the case of traumatic avulsion. Following tumor excision, bilamellar repair was performed using composite grafts for the posterior lamella and skinmuscle flaps for the anterior lamella. Graft necrosis oc

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Total Eyelid Reconstruction with Free Dorsalis Pedis Flap after Deep Facial Burn

Cited by 31 publications

References 0 publications

Microvascular Free Flap for Total Eyelid Reconstruction With a Visually Useful Eye

Microvascular Free Flap for Total Eyelid Reconstruction With a Visually Useful Eye

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

Techniques and Outcomes of Total Upper and Lower Eyelid Reconstruction

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