Abstract

PAMPIN MARTINEZ, Marta María  and  CASTILLO PARDO DE VERA, José Luis del. Medial canthal and eyelid reconstruction using the split paramedian forehead flap: a case report. Rev Esp Cirug Oral y Maxilofac [online]. 2020, vol.42, n.1, pp.29-31.  Epub May 04, 2020. ISSN 2173-9161.  https://dx.doi.org/10.20986/recom.2020.1062/2019.

Medial eyelid/canthal defects are difficult to reconstruct. This region has both functional an cosmetic importance in facial esthetics. The lacrimal apparatus drains in the medial canthal area and both eyelids protect the eye from dryness and exposure, so damage to this organs may have severe ophthalmic consequences. Furthermore, the medial canthal area owns a complex concave surface difficult to replace satisfactorily. Poor reconstruction techniques may have undesirable cosmetic outcomes, which may be easily noticeable.

The paramedian forehead flap is a mainly used in nasal reconstruction. It has a reliable vascu­larity and allows a wide arc of rotation. Plus, trimming and recontouring of the flap may be done to offer the best results. Several modifications of the flap have been purposed in the literature. The paramedian forehead flap may be a good choice for medial canthal/eyelid reconstruction as well, given the characteristics aforementioned. We present a case of an 88 year old woman who presented with a medial eyelid/canthal defect following resection of a squamous cell carcinoma. Reconstruction with a contralateral split paramedian forehead flap was achieved.

We conclude that the paramedian forehead flap may represent a safe and simple alternative in medial eyelid/canthal reconstruction, preserving eyelid function and offering acceptable cosmetic results with minor donor site morbidity.

Keywords : Paramedian forehead flap; medial canthal reconstruction; eyelid reconstruction.

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