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Lateral frontal galeal-cutaneous flap for reconstruction after orbital exenteration for advanced periorbital skin cancer.

PMID: 32927925 (view PubMed database entry)
DOI: 10.3906/sag-1809-170 (read at publisher's website )

Predrag Kovacevic, Jasmina Djordjevic-Jocic, Milan Radojkovic,

BACKGROUND/AIM:Orbital exenteration is one of the most disfiguring procedures leading to significant deformity. Defect reconstruction is challenging, especially in elderly patients. We have reviewed our experience of orbital exenteration and primary reconstruction with lateral frontal galeal-cutaneous flap based on superficial temporal artery. MATERIALS AND METHODS:Data on patients treated for non-melanoma skin cancer invading the orbit during the 10-year period were analyzed. Patients? demographics, tumor features, reconstructive technique used, complications and survival were recorded with a median follow-up of 27.5 months. RESULTS:26 patients in whom orbital exenteration was done were included in the study. There were 14 males and 12 females, mean aged 75.29 years (ranged 61-87). The majority of patients were treated for basal cell carcinoma with medial cantus as primary site. All defects were closed by lateral frontal galeal- cutaneous flap based on superficial temporal artery, and in two cases temporalis muscle pedicle flap was used as additional flap for reconstruction of orbital roof in order to separate the brain from empty orbit, and covered with same galeal-cutaneous flap. In 19 cases frontal area was closed primarily, and in 7 cases skin graft was used for secondary defect. There was no flap loss. Tumor related death was registered in three patients (inoperable recurrent tumors) (11.5%), 7 died as tumor unrelated (2 of them were operated from recurrent orbital tumor) and 16 survived. CONCLUSION:The preferred method for reconstruction after orbital exenteration in our university affiliated center is lateral frontal galeal-cutaneous flap based on superficial temporal artery. The flap harvesting is simple, safe and obtains enough tissue for covering defects even after extended exenteration. Complication rate is low. We suggest the simultaneous use of this flap with pedicle temporalis muscle flap only for reconstruction of scull base after anterior cranial fossa resection.

Turk J Med Sci (Turkish journal of medical sciences)
[2020, :]

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