Anatomical study of forehead flap with its pedicle based on cutaneous branch of supratrochlear artery and its application in nasal reconstruction.
ABSTRACT This study was conducted to investigate whether there is a consistent cutaneous branch by anatomic research of the supratrochlear artery. Ten fresh adult cadavers were selected. Anastomosis between the supratrochlear artery and supraorbital artery was observed. The mean distance from the supraorbital rim to the supratrochlear artery was 1.18 +/- 0.36 cm. A consistent cutaneous branch of the supratrochlear artery increased in a position 1.35 +/- 0.34 cm lateral to the midline that anastomosed abundantly with the cutaneous branch, the muscular branch of the opposite side, the ipsilateral muscular branch, and bilateral supraorbital arteries. An ultrathin forehead skin flap with the cutaneous branch as the blood vessel was designed and used for nasal reconstruction in 15 cases. Postoperatively, all flaps survived successfully with satisfactory surgical results. The advantages of the flap are its thin feature and preservation of the entirety of the frontalis muscle.
[Show abstract] [Hide abstract]
ABSTRACT: Background The reconstruction of nasal and periorbital defects has been a challenging task for plastic surgeons in terms of obtaining aesthetic and functional results. So far, many surgical methods have been described for the closure of these defects; however, the lack of sensation and inadequate cosmetic appearance were the main disadvantages of these procedures. Methods This study involved all patients who underwent reconstruction of nasal and periorbital defects due to tumor resection by means of a supratrochlear artery island flap, between 2007 and 2011. Doppler USG on the frontal region was routinely performed on all of the patients. Results This technique was used in six male patients with a mean age of 59.6 years (ranged, 44–68 years).The flap sizes ranged from 3 × 2.2 to 5 × 4.5 cm (mean 3.83 × 3.13 cm). The mean follow-up period was 23.6 months. All of the flaps survived without any problem, and no total or partial loss of flap was observed. The defects were closed with sensate and durable skin. Temporary loss of sensation on frontal regions was observed on all of the patients, but it decreased within 8–12 months in the follow-ups. Conclusions The supratrochlear artery island flap is a good alternative for the reconstruction of small- and medium-sized periorbital and nasal defects that offers a single-stage procedure, good perfusion and drainage, reliability, technical easiness, and sensorial superiority. Level of Evidence: Level IV, therapeutic study.European Journal of Plastic Surgery 01/2014; DOI:10.1007/s00238-013-0895-3
[Show abstract] [Hide abstract]
ABSTRACT: Reconstruction of nasal defects is challenging because it requires covering skin, supporting framework, and lining. Traditionally, the forehead flaps are transferred in 2 stages; however, it can be accomplished in a single stage or in 3 stages. Few published studies are available about the paramedian forehead flap using the intermediate stage (3-stage) and the aesthetic subunits principle. The purpose of this study is to evaluate the use of the paramedian forehead flap in 2 and 3 stages for nasal reconstructions, highlighting the indications, complications, and technical details and evaluating the patient's satisfaction through a questionnaire about the quality of life (Derriford Appearance Scale 24). A retrospective review was performed between 2011 and 2013 for a consecutive series of 11 patients who underwent nasal reconstructions using the paramedian forehead flap in 2 or 3 stages. All preoperative and postoperative data were collected, and outcomes were also assessed through a questionnaire about the patients' postoperative quality of life. The causes of nasal lesions varied among skin cancer, trauma, and infection. Two-stage paramedian forehead flap reconstruction was performed upon 4 patients, whereas the 3-stage reconstruction was performed for 7 patients. Of the 10 survey respondents, 6 were highly satisfied (score of 11-27), and 4 were moderately satisfied (score of 28-44), whereas no one was dissatisfied after his/her surgical nasal reconstruction procedure. Whether the approach is accomplished in 2 or 3 stages, all areas of the reconstructed nose must be firmly supported. Applying the nasal subunits principle seems to contribute to an overall satisfied population in our study, according to the score obtained by the questionnaire about quality of life.Journal of Craniofacial Surgery 11/2014; 25(6):2070-3. DOI:10.1097/SCS.0000000000001152 · 0.68 Impact Factor