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Related Experiment Video

Updated: Feb 13, 2026

Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

Published on: December 5, 2025

Revision eDCR using a superior pedicled mucosal flap.

Sarina K Mueller^1,2, Suzanne K Freitag³, Daniel R Lefebvre³

¹a Department of Otolaryngology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA.

Orbit (Amsterdam, Netherlands)

|March 9, 2018

Summary

Revision endoscopic dacryocystorhinostomy (eDCR) can be challenging. A novel superiorly based mucosal flap technique offers a vascularized approach for revision eDCR, improving surgical outcomes and long-term patency.

Keywords:

Endoscopy granulation tissue nasolacrimal duct obstruction pedicled flap tears

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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

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Engineered Vascularized Muscle Flap

Engineered Vascularized Muscle Flap

Published on: January 11, 2016

Area of Science:

Ophthalmology
Otorhinolaryngology
Surgical Innovation

Background:

Endoscopic dacryocystorhinostomy (eDCR) has high patency rates but revision cases present challenges.
Identifying the correct osteotomy site and maintaining patency in scarred tissue are key difficulties in revision eDCR.
Previous flap techniques may compromise blood supply in revision surgeries.

Purpose of the Study:

To describe a novel superiorly based mucosal flap technique for revision endoscopic dacryocystorhinostomy (eDCR).

Main Methods:

The technique involves a superiorly based mucosal flap designed to preserve vascularity.
This approach allows for wide exposure of the revision osteotomy site.
The viable mucosal flap is replaced post-procedure to minimize bone exposure and scarring.

Main Results:

The technique was used in 13 revision eDCR procedures.
Achieved 100% identification of the lacrimal sac.
Reported a 0% complication rate and 100% success rate at a mean follow-up of 26.93 months.

Conclusions:

The superior pedicled mucosal flap technique provides excellent surgical exposure for revision eDCR.
This method preserves flap vascularity, typically unaffected by prior DCR procedures.
Replacing the flap minimizes bone exposure, reduces cicatricial restenosis, and optimizes long-term patency.