Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-05-2013 | Head and Neck

Free flaps in orbital exenteration: a safe and effective method for reconstruction

Authors: Fernando López, Carlos Suárez, Susana Carnero, Clara Martín, Daniel Camporro, José L. Llorente

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2013

Abstract

The aim of this study was to investigate the course of reconstructive treatment and outcomes with use of free flaps after orbital exenteration for malignancy. Charts of patients who had free flap reconstruction after orbital exenteration were retrospectively reviewed and the surgical technique was evaluated. Demographics, histology, surgical management, complications, locoregional control, and survival were analyzed. We performed 22 flaps in 21 patients. Reconstruction was undertaken mainly with anterolateral thigh (56 %), radial forearm (22 %), or parascapular (22 %) free flaps. Complications occurred in 33 % of patients and the flap’s success rate was 91 %. The 5-year locoregional control and survival rates were 42 and 37 %, respectively. Free tissue transfer is a reliable, safe, and effective method for repair of defects of the orbit and periorbital structures resulting from oncologic resection. The anterolateral thigh flap is a versatile option to reconstruct the many orbital defects encountered.

Rapidis AD, Liarikos S (1998) Malignant orbital and orbitomaxillary tumors: surgical considerations. Orbit 17:77–88PubMedCrossRef

Chepeha DB, Wang SJ, Marentette LJ et al (2004) Restoration of the orbital aesthetic subunit in complex midface defects. Laryngoscope 114:1706–1713PubMedCrossRef

Pryor SG, Moore EJ, Kasperbauer JL (2005) Orbital exenteration reconstruction with rectus abdominis microvascular free flap. Laryngoscope 115:1912–1916PubMedCrossRef

Taylan G, Yildirim S, Akoz T (2006) Reconstruction of large orbital exenteration defects after resection of periorbital tumors of advanced stage. J Reconstr Microsurg 22:583–589PubMedCrossRef

Camporro D, Fueyo A, Llorente JL, Sánchez J, Vega C, Martín C (2003) Reconstrucción de la zona donante del colgajo de antebrazo libre radial mediante colgajo de avance- rotación cubital. Cir Plast Iberlatinamer 29:191–197

Suarez C, Llorente JL, de Fernandez León R, Maseda E, Lopez A (2004) Prognostic factors in sinonasal tumors involving the anterior skull base. Head Neck 26:136–144PubMedCrossRef

Suárez C, Ferlito A, Lund VJ et al (2008) Management of the orbit in malignant sinonasal tumors. Head Neck 30:242–250PubMedCrossRef

Imola MJ, Schramm VL Jr (2002) Orbital preservation in surgical management of sinonasal malignancy. Laryngoscope 112:1357–1365PubMedCrossRef

Manabe J, Kawaguchi N, Matsumoto S, Tanizawa T (2005) Surgical treatment of bone metastasis: indications and outcomes. Int J Clin Oncol 10:103–111PubMedCrossRef

10.

Hanasono MM, Lee JC, Yang JS, Skoracki RJ, Reece GP, Esmaeli B (2009) An algorithmic approach to reconstructive surgery and prosthetic rehabilitation after orbital exenteration. Plast Reconstr Surg 123:98–105PubMedCrossRef

11.

Menderes A, Yilmaz M, Vayvada H, Demirdover C, Barutçu A (2002) Reverse temporalis muscle flap for the reconstruction of orbital exenteration defects. Ann Plast Surg 48:521–526PubMedCrossRef

12.

Chiu ES, Kraus D, Bui DT et al (2008) Anterior and middle cranial fossa skull base reconstruction using microvascular free tissue techniques (surgical complications and functional outcomes). Ann Plast Surg 60:514–520PubMedCrossRef

13.

Camporro D, Fueyo A, Martín C, Carnero S, Llorente JL (2011) Use of lateral circumflex femoral artery system free flaps in skull base reconstruction. J Craniofac Surg 22:888–893PubMedCrossRef

14.

Chicarilli ZN, Davey LM (1987) Rectus abdominis myocutaneous free-flap reconstruction following a cranio-orbital-maxillary resection for neurofibrosarcoma. Plast Reconstr Surg 80:726–731PubMedCrossRef

15.

Heth JA, Funk GF, Karnell LH et al (2002) Free tissue transfer and local flap complications in anterior and anterolateral skull base surgery. Head Neck 24:901–911PubMedCrossRef

16.

Spiegel J, Varvares M (2007) Prevention of postexenteration complications by obliteration of the orbital cavity. Skull Base 17:197–203PubMedCrossRef

17.

Kuo CH, Gao K, Clifford A, Shannon K, Clark J (2011) Orbital exenterations: an 18-year experience from a single head and neck unit. ANZ J Surg 81:326–330PubMedCrossRef

Title: Free flaps in orbital exenteration: a safe and effective method for reconstruction
Authors: Fernando López
Carlos Suárez
Susana Carnero
Clara Martín
Daniel Camporro
José L. Llorente
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2013
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-012-2308-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Free flaps in orbital exenteration: a safe and effective method for reconstruction

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2013

Health costs and consequences: have UK national guidelines had any effect on tonsillectomy rates and hospital admissions for tonsillitis?

Combined endoscopic–transcutaneous surgery in parotid gland sialolithiasis and other ductal diseases: reporting medium- to long-term objective and patients′ subjective outcomes

Translation, cross-cultural adaptation, and validation of the sino-nasal outcome test (SNOT)-22 for Lithuanian patients

Interleukin-17A contributes to the expression of serum amyloid A in chronic rhinosinusitis with nasal polyps

Utility of an intraoperative ultrasound in lateral approach mini-parathyroidectomy with discordant pre-operative imaging

Post laryngectomy speech rehabilitation outcome in elderly patients