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Reconstruction after orbital exenteration using gracilis muscle free flap
Fabio Nicoli1, Ram M Chilgar, Stamatis Sapountzis
1Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata, ", Rome, Italy.
Microsurgery
|October 21, 2014
Summary
The gracilis free flap offers a safe and effective method for orbital exenteration (OE) reconstruction, providing good cosmetic results with minimal donor site complications. This technique is a viable option for restoring function and appearance after extensive tissue removal.
Area of Science:
- Reconstructive surgery
- Plastic surgery
- Ophthalmology
Background:
- Orbital exenteration (OE) is a radical surgical procedure involving the removal of orbital contents due to malignancy or trauma.
- Reconstruction following OE is challenging, aiming to restore both form and function.
- Various reconstruction methods have been explored with variable success rates.
Purpose of the Study:
- To evaluate the efficacy and feasibility of using the gracilis muscle free flap for orbital exenteration defect reconstruction.
- To assess the prosthetic rehabilitation potential following gracilis free flap reconstruction.
- To analyze patient and surgeon satisfaction with cosmetic outcomes.
Main Methods:
- Retrospective review of nine consecutive patients undergoing gracilis free flap reconstruction after OE.
- Patients were treated between January 2009 and January 2013 at China Medical University Hospital.
- Causes for OE included malignancy in six patients and trauma in three.
Main Results:
- All nine patients achieved successful reconstruction with gracilis free tissue transfer.
- No donor or recipient site morbidity was reported.
- Acceptable cosmetic results were achieved, and the mean follow-up was 23.5 months.
Conclusions:
- Gracilis free flap reconstruction is a safe and effective alternative for orbital exenteration defects.
- The flap provides ample well-vascularized tissue with flexibility in placement and minimal donor site morbidity.
- This method supports prosthetic rehabilitation without significant functional deficits.
