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Medial canthal reconstruction with multiple local flaps.

Akihiro Ogino1, Kiyoshi Onishi1, Emi Okada1

  • 1Department of Plastic and Reconstructive Surgery, Toho, University Omori Medical Center, Tokyo, Japan.

JPRAS Open
|March 12, 2020
PubMed
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This summary is machine-generated.

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The Journal of craniofacial surgery·2020

Reconstructing large medial canthal defects after skin cancer removal is challenging. This study successfully used multiple local flaps for aesthetic and functional restoration in four patients.

Area of Science:

  • Plastic Surgery
  • Ophthalmology
  • Dermatologic Surgery

Background:

  • Reconstructing extensive medial canthal defects presents significant challenges.
  • Large defects often involve adjacent eyelid structures, complicating surgical repair.
  • Malignant skin tumor resection frequently results in such defects.

Purpose of the Study:

  • To evaluate the efficacy of a multi-local flap technique for medial canthal reconstruction.
  • To assess the aesthetic and functional outcomes of this reconstructive approach.
  • To demonstrate a method for managing complex defects involving the medial canthus and eyelids.

Main Methods:

  • Four patients with large medial canthal defects underwent reconstruction using a combination of local flaps.
  • A glabellar flap was used for the medial canthal defect, an upper eyelid myocutaneous advancement flap for the upper eyelid, and a cheek rotation flap for the lower eyelid.
Keywords:
Glabellar flapMedial canthal reconstructionOrbicularis oculi myocutaneous flapRintala flap

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  • The glabellar flap donor site was covered with a Rintala flap.

    • Main Results:

    • All four patients achieved successful reconstruction with no tumor recurrence.
    • Good aesthetic and functional results were reported.
    • One patient experienced mild linear contracture, which did not require further intervention.

    Conclusions:

    • This multi-local flap technique, while complex, offers a viable and simple reconstructive solution for extensive medial canthal defects.
    • Integrating flap design with facial unit borders minimizes visible scarring.
    • The use of adjacent flaps ensures aesthetic continuity in color and texture, enhancing patient outcomes.