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Updated: Apr 26, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
902
Defect components and reconstructive options in composite orbitomaxillary defects with orbital exenteration.
Shawn T Joseph1, Krishnakumar Thankappan2, Jimmy Mathew3
1Assistant Professor, Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Summary
Reconstructing orbital exenteration and maxillectomy defects often involves soft tissue flaps like the rectus abdominis. For complex cases, composite flaps offer a viable solution for orbital reconstruction.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Orbital exenteration and maxillectomy defects present complex reconstructive challenges.
- Conventional reconstruction often combines soft tissue free flaps with orbital prostheses.
- Bone flap utilization has been reported but is less common.
Purpose of the Study:
- To review and analyze reconstructive options for defects following orbital exenteration and maxillectomy.
- To evaluate the efficacy of different reconstructive techniques in addressing these complex defects.
- To compare outcomes of soft tissue versus bony reconstructions.
Main Methods:
- Retrospective case series analysis of 20 patients.
- Review of electronic medical records, operative notes, and follow-up data.
- Analysis of reconstructive components, flap types (bony vs. soft tissue), and prosthetic rehabilitation.
Main Results:
- Fourteen patients received soft tissue reconstruction; six underwent bony reconstruction.
- The free rectus abdominis flap was the most frequently used soft tissue flap.
- The study assessed the utility of various flaps in replacing specific defect components.
Conclusions:
- Optimal reconstruction necessitates addressing all defect components: facial contour, orbital, palatal, skull base, and skin.
- The free rectus abdominis flap remains a primary choice for soft tissue coverage.
- Composite reconstruction using the tensor fascia lata flap with iliac crest bone and internal oblique muscle is a viable option for socket reconstruction.
