The Use of Axial Based Superficial Temporal Artery Frontal Branch Island Flap in Reconstruction of Full Thickness Extensive Lateral Canthus and Eyelid Defects

Abstract

Objective: Full-thickness and extensive eyelid defect reconstruction including lateral canthus is complex and difficult as a result of complex structure of area. To close defects in this region with good texture and to obtain successful functional and aesthetic results, good vascularized skin and soft tissue play an impor-tant role. 

Patient and methods: A total of 7 patients with extensive full thickness eyelid and lateral canthus defects reconstructed with axial superficial temporal artery frontal branch island flap in Manisa Celal Bayar University Faculty of Medicine Hospital between May 2014 and December 2015 included in the study. 

Results: 7 patients were operated with this tecnique. 4 of them were female. Mean age was 64.4 and mean follow-up period was 13 months. Three patients had basal cell carcinoma, 2 had squamous cell carcinoma and one had trichoblastic carcinoma. One patients’ defect was secondary to trauma. Four total lower lid defects, 2 lateral canthus defects and one total upper lid defect were reconstructed with this tecnique. Two patients’ flap donor area were reconstructed with split thickness skin graft. One patient needed lateral cantoplasty for lateral fissur widening 6 month after surgery and one patient needed  lateral canthopexy secondary to mild ectropion 6 month after surgery. 

Conclusion: Island flap based on terminal frontal branch of the superficial temporal artery ensures a reliable and valuable option with acceptable aesthetic and functional coverage without need of cartilage graft for tarsus and mucosa graft for palpebral conjunctiva reconstruction.

Keywords

• eyelid,lateral canthus,reconstruction,superficial temporal artery

Aksiyel Bazlı Yüzeyel Temporal Arter Ada Flebinin Tam Kat Geniş Lateral Kantus ve Gözkapağı Defektlerinde Kullanımı

Abstract

Amaç: Lateral kantus da dahil olmak üzere tam kat ve geniş göz kapağı defekti rekonstrüksiyonu, karma-şık ve kompleks yapının bir sonucu olarak zordur. Bu bölge defektlerini kapatmak, başarılı fonksiyonel ve estetik sonuçlar elde etmek için iyi vaskülarize cilt ve yumuşak doku önemli bir rol oynamaktadır.

Hasta ve yöntem: Çalışmaya Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi'nde Mayıs 2014-Aralık 2015 tarihleri arasında aksiyel süperfisyal temporal arter frontal dal ada flebi ile rekonstrüksiyon yapılan tam kalınlıkta göz kapağı ve lateral kantus defekti olan toplam 7 hasta dahil edildi.

Bulgular: Bu teknikle 7 hasta ameliyat edildi. Dört tanesi kadındı. Ortalama yaş 64.4 ve ortalama takip süresi 13 ay idi. Üç hastada bazal hücreli karsinom, 2 hastada skuamöz hücreli karsinom, bir hastada tri-koblastik karsinom tespit edildi. Bir hasta defekti ise travmaya sekonder idi. Bu teknikle toplam 4 alt ka-pak total tam kat defekti, 2 lateral kantus defekti ve bir total tam kat üst kapak defekti rekonstrükte edildi. İki hastada flep donör alanı, kısmi kalınlıkta deri grefti ile onarıldı. Bir hasta ameliyattan 6 ay sonra lateral kantal fissurun genişletilmesi için lateral kantoplastiye ihtiyaç duydu. Bir hasta ise ameliyattan 6 ay sonra hafif ektropiyona sekonder lateral kantopeksiye gereksinim duydu.

Sonuç: Yüzeysel temporal arterin terminal frontal dalı bazlı ada flebi, palpebral konjonktiva rekonstrüksi-yonu için mukoza grefti ve tars rekonstrüksiyonu için kıkırdak grefti gerekmeksizin kabul edilebilir este-tik ve fonksiyonel onarım için güvenilir ve değerli bir seçenektir.

Keywords

• eyelid,lateral canthus,reconstruction,superficial temporal artery

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