An original procedure for orbitonasal cutaneous infiltrative tumor repair, using combined forehead and melolabial propeller flaps
- 10 Downloads
Resections of cutaneous tumors in the medial orbitonasal region can be transfixing. Repairs using a single local flap run the risk of failure and that of secondary sinonasal fistula, especially in cases of surgery on a radiated field. We propose an original and reliable repair procedure using two pedicled regional flaps vascularized by two distinct arterial systems clinched together to reconstruct the mucosal and cutaneous planes.
Materials and methods
A first melolabial propeller flap (MPF) with a superior perforating pedicle was elevated and the cutaneous side was sutured to the deep plane of the loss of substance (mucosal lining). A second homolateral or contralateral paramedian forehead flap (PFF) was then lifted and sutured over the first flap (superficial plane). The forehead pedicle flap was divided at 1 month.
No trophic complication or failure was recorded on two patients. The 7-year carcinologic, aesthetic, and functional results were satisfying.
This technique involving the superimposition of two local flaps, vascularized by two different arterial systems, appears to offer a simple and reliable repair technique for transfixing cutaneous losses of substance in the medial orbitonasal region. It could be used in the first-line treatment, particularly if an additional radiotherapy is to be performed.
KeywordsNasocutaneous fistula Medial canthus Paramedian forehead flap Melolabial propeller flap
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 3.Olivier Camuzard MD, Rémi Foissac MD, Charalambos Georgiou MD et al (2015) Facial artery perforator flap for reconstruction of perinasal defects: an anatomical study and clinical application. J Craniomaxillofac Surg 43:2057–2065. https://doi.org/10.1016/j.jcms.2015.10.015 CrossRefPubMedGoogle Scholar
- 8.Brüe E, Bey E, CARIOU JL (2000) L’artère faciale. Rappel embryologique, anatomie descriptive et fonctionnelle d’après une revue de la littérature. Ann Chir Plast esthétique 45:461–484Google Scholar
- 20.Singh DJ, Bartlett SP (2003) Aesthetic considerations in nasal reconstruction and the role of modified nasal subunits. Plast Reconstr Surg 111:639–648.(discussion 649–651) https://doi.org/10.1097/01.PRS.0000041602.85239.93 CrossRefPubMedGoogle Scholar
- 26.Leatherbarrow B, Watson A, Wilcsek G Use of the pericranial flap in medial canthal reconstruction: another application for this versatile flap. Ophthalmic Plast Reconstr Surg 22:414–419. https://doi.org/10.1097/01.iop.0000243606.14193.34 CrossRefGoogle Scholar