|
KMID : 0903220110120010048
|
|
Journal of the Korean Cleft Palate-Craniofacial Association
2011 Volume.12 No. 1 p.48 ~ p.52
|
|
|
Lower Eyelid Full-Thickness Reconstruction Using a Radial Forearm Free Flap with Palmaris Longus Tendon Sling: A Case Report
|
|
Kim Tae-Hoon
Eun Seok-Chan
Baek Rong-Min
|
|
|
Abstract
|
|
|
Purpose: Many advances have been made in lower eyelid reconstruction surgical procedures after tumor ablative therapy. These include skin grafts, local flaps, free flaps, and skin expansion. When a full-thickness defect of the lower eyelid is reconstructed with many free flaps, ectropion and deformity of the medial and lateral canthal areas are common late complications caused by gravitational descent. The radial forearm free flap is widely used because of its lack of bulk, ease of dissection, malleability, and hairlessness. This report introduces a novel method for preventing ectropion using a composite radial forearm free flap reconstruction and palmaris longus suspension technique.
Methods: A 70-year-old man had a malignant melanoma on his left lower eyelid. The patient was referred to our department after a biopsy confirmed the initial diagnosis. A full-thickness wide resection with a 25mm free margin was performed, and a 5×8cm radial forearm flap was elevated with a vascularised palmaris longus tendon. The palmaris longus tendon was fixed to the medial and lateral orbital rim perisoteum and the deep temporal fascia. The buccal mucosa was grafted to reconstruct the inner conjunctival layer. The pedicle vessels were anastomosed to the left superficial temporal artery and vein.
Results: The postoperative clinical course was uneventful. The flap showed good texture and color match. No ectropion was noted 14 months after surgery and the tumor did not recur. The patient was quite satisfied with the final outcomes.
Conclusion: Use of a radial forearm free flap and the palmaris longus tendon is an effective method for a full-thickness lower eyelid reconstruction.
|
|
|
KEYWORD
|
|
|
Lower eyelid, Malignant melanoma, Radial forearm flap, Palmaris longus
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|