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Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

BACKGROUND: The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect...

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Autores principales: Kim, Jin Hyung, Kim, Jeong Min, Park, Jang Wan, Hwang, Jae Ha, Kim, Kwang Seog, Lee, Sam Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Plastic and Reconstructive Surgeons 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840182/
https://www.ncbi.nlm.nih.gov/pubmed/24286048
http://dx.doi.org/10.5999/aps.2013.40.6.742
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author Kim, Jin Hyung
Kim, Jeong Min
Park, Jang Wan
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
author_facet Kim, Jin Hyung
Kim, Jeong Min
Park, Jang Wan
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
author_sort Kim, Jin Hyung
collection PubMed
description BACKGROUND: The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. METHODS: This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. RESULTS: All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. CONCLUSIONS: Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.
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spelling pubmed-38401822013-11-27 Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap Kim, Jin Hyung Kim, Jeong Min Park, Jang Wan Hwang, Jae Ha Kim, Kwang Seog Lee, Sam Yong Arch Plast Surg Original Article BACKGROUND: The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. METHODS: This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. RESULTS: All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. CONCLUSIONS: Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches. The Korean Society of Plastic and Reconstructive Surgeons 2013-11 2013-11-08 /pmc/articles/PMC3840182/ /pubmed/24286048 http://dx.doi.org/10.5999/aps.2013.40.6.742 Text en Copyright © 2013 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jin Hyung
Kim, Jeong Min
Park, Jang Wan
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title_full Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title_fullStr Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title_full_unstemmed Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title_short Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap
title_sort reconstruction of the medial canthus using an ipsilateral paramedian forehead flap
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840182/
https://www.ncbi.nlm.nih.gov/pubmed/24286048
http://dx.doi.org/10.5999/aps.2013.40.6.742
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