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Orbital exenteration reconstruction with rectus abdominis microvascular free flap
Shepherd G Pryor1, Eric J Moore, Jan L Kasperbauer
1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
The Laryngoscope
|December 2, 2005
Summary
The rectus abdominis free flap offers a safe and effective method for reconstructing orbital exenteration defects, achieving high success rates and patient satisfaction. This technique provides a reliable alternative for complex head and neck reconstructions.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Orbital exenteration and total maxillectomy often necessitate complex reconstructive procedures.
- Free flap reconstruction is a critical component in restoring function and aesthetics after extensive oncologic resections.
Purpose of the Study:
- To evaluate the reconstructive treatment course and outcomes using the rectus abdominis free flap.
- To assess the efficacy of this flap in patients undergoing orbital exenteration with or without total maxillectomy.
Main Methods:
- Retrospective chart review of patients (1994-2004) at Mayo Clinic.
- Analysis of surgical technique, outcomes, and patient/surgeon satisfaction.
Main Results:
- Successful reconstruction in 12 of 13 patients (92% flap viability).
- Acceptable cosmetic outcomes reported by both patients and surgeons.
- The rectus abdominis flap demonstrated advantages in tissue volume and placement flexibility.
Conclusions:
- Rectus abdominis microvascular free-tissue transfer is a safe and reliable option for orbital exenteration repair.
- It offers advantages over temporalis or pectoralis major flaps, including larger tissue volume and flexible placement.
- The flap facilitates obturation of maxillectomy defects and simplifies post-operative care.