Reconstruction of the Exenterated Orbit with an Island Pericranial Flap: A New Surgical Approach
| Autor: | Sophia Kuehnel, András Grimm, MD, Christopher Bohr, MD, Werner Hosemann, MD, Rainer Weber, MD, Tobias Ettl, MD, Thomas Kuehnel, MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Plastic and Reconstructive Surgery, Global Open, Vol 11, Iss 7, p e5082 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2169-7574 00000000 |
| DOI: | 10.1097/GOX.0000000000005082 |
| Popis: | Background:. Reconstruction of the bony socket after orbital exenteration is a matter of much debate. Prompt defect closure with a microvascular flap is desirable but involves a major surgical procedure and hence, places considerable burden on the patient. The new surgical technique presented here permits a technically simpler wound closure with fewer complications after orbital exenteration. Methods:. Between May 2014 and June 2022 in the ENT department of Regensburg University, nine patients underwent exenteration and reconstruction with a pericranial flap. The flap was raised via a broken line incision in the forehead or endoscopically, incised in a roughly croissant-like shape, then introduced into the orbit through a tunnel in the eyebrow. A retrospective analysis of the patients and considerations about determining the size, shape, and vascular supply of the flap are presented. Results:. Flap healing was uncomplicated in all cases. Only 6 weeks after surgery, the flap was stable, making it possible to start adjuvant therapy and prosthetic rehabilitation swiftly. The flap is adapted to the near cone-shape of the orbit. The mean (± standard deviation) surface area of the measured orbits is (39.58 ± 3.32) cm2. The territory of the angular artery provides the periosteal flap arterial blood supply. Venous drainage is via venous networks surrounding the artery. Conclusions:. Use of the pericranial flap makes it possible to close the orbital cavity promptly with minimal donor site defect and a short operating time, thereby minimizing the surgical risk and speeding up physical and psychological recovery. |
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