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Supraorbital Rim and Roof Reconstruction with Vascularized Fascia Lata and Autogenous Rib Graft
Sara W Liu1, Ariel Frost1, Michael A Fritz1
1Cleveland Clinic, Head and Neck Institute, Section of Facial Plastic and Microvascular Surgery, Cleveland, Ohio, U.S.A.
The Laryngoscope
|June 15, 2023
Summary
This study presents a new surgical method for reconstructing complex orbital defects using rib grafts and fascia lata flaps, achieving excellent patient outcomes with minimal complications. The technique ensures structural integrity and cosmetic symmetry for the supraorbital rim and orbital roof.
Area of Science:
- Neurosurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Complex defects of the supraorbital rim and orbital roof often require specialized reconstruction techniques.
- Traditional methods may face challenges in achieving both structural integrity and aesthetic outcomes.
Purpose of the Study:
- To describe a novel surgical technique for reconstructing complex defects involving the supraorbital rim and orbital roof.
- To evaluate the functional and cosmetic outcomes of this reconstruction method.
Main Methods:
- Retrospective review of four patients undergoing tumor resection requiring supraorbital rim and orbital roof reconstruction.
- Utilized autogenous osseous rib graft for structure and anterolateral thigh fascia lata (ALTFL) free flap for vascularity and coverage.
- Flaps were vascularized via superficial temporal vessels.
Main Results:
- All four patients achieved excellent contour symmetry and maintained orbital volume post-reconstruction.
- No vision changes or diplopia were reported.
- High graft retention rates and minimal complications were observed, including one cerebrospinal fluid leak and one case of mild enophthalmos.
Conclusions:
- The described novel technique using autogenous osseous rib and vascularized ALTFL-free flap provides excellent functional and cosmetic results for complex supraorbital rim and orbital roof defects.
- Minimal access techniques can be employed to reduce patient morbidity.
