Tasch Christoph, Pattiss Alexander, Lanthaler Monika, Pierer Gerhard
University Hospital for Plastic, Reconstructive and Aesthetic Surgery Innsbruck, Medical University Innsbruck, Innsbruck, Austria.
Plast Reconstr Surg Glob Open. 2022 Jan 27;10(1):e4074. doi: 10.1097/GOX.0000000000004074. eCollection 2022 Jan.
The reconstruction of medial canthal defects is often challenging in achieving continuity of color and texture, obtaining adequate tissue for large defects, and the reproduction of natural external appearance with inconspicuous scars. We describe a technique for reconstruction of the medial canthal area, using a modified rhomboid flap.
The technique is based on the use of a modified rhomboid flap for medial canthal defects-superiorly based on the root of the nose for defects mostly above the medial canthal tendon, inferiorly based on the cheek for defects mostly below the medial canthal tendon, and in cases of large defects, using a combination of the two flaps. We present a case series of five patients successfully reconstructed with the mentioned technique after resection of medial canthal basal cell carcinoma.
Of the five patients with a mean age of 76.2 years (range 62-84 years), reconstruction was performed in three patients with a superiorly based rhomboid flap, in one patient with an inferiorly based rhomboid flap, and in another patient with a large defect using a combination of the two flaps. Mean follow-up was 374.4 days (range 30-1247 days). All patients achieved a complete primary closure with no further surgery and satisfactory cosmetic and functional results.
The modified rhomboid flap is a simple and reliable technique for all defects of the medial canthal area.
内眦缺损的重建在实现颜色和质地的连续性、为大的缺损获取足够的组织以及通过不明显的瘢痕再现自然外观方面常常具有挑战性。我们描述一种使用改良菱形皮瓣重建内眦区域的技术。
该技术基于使用改良菱形皮瓣修复内眦缺损——对于大多在内眦腱上方的缺损，以鼻根部为皮瓣上蒂；对于大多在内眦腱下方的缺损，以脸颊为皮瓣下蒂；对于大的缺损，联合使用这两种皮瓣。我们展示了一组5例患者的病例系列，这些患者在内眦基底细胞癌切除术后成功地采用上述技术进行了重建。
5例患者平均年龄76.2岁（范围62 - 84岁），其中3例采用上蒂菱形皮瓣进行重建，1例采用下蒂菱形皮瓣进行重建，另1例大的缺损联合使用这两种皮瓣进行重建。平均随访374.4天（范围30 - 1247天）。所有患者均实现了一期完全闭合，无需进一步手术，且获得了满意的美容和功能效果。
改良菱形皮瓣是一种用于内眦区域所有缺损的简单且可靠的技术。
