title: Orbital exenteration reconstruction with rectus abdominis microvascular free flap.
abstract: OBJECTIVE
  To determine the course of reconstructive treatment and outcomes with use of the rectus abdominis free flap after orbital exenteration with or without total maxillectomy.
  
  
  METHODS
  Retrospective chart review of treatment and outcomes of patients who had rectus abdominis free-tissue transfer for orbital exenteration with or without total maxillectomy at the Mayo Clinic between 1994 and 2004.
  
  
  METHODS
  Charts of patients who had rectus abdominis free flap reconstruction after orbital exenteration were retrospectively reviewed and the surgical technique evaluated. An explanation of the surgical technique for rectus abdominis free-tissue transfer to the orbital cavity is provided, along with a discussion of the advantages and disadvantages of this reconstructive method.
  
  
  RESULTS
  Twelve of 13 patients who underwent reconstruction with rectus abdominis free-tissue transfer had a successful outcome (flap viability 92%). Cosmetic results were acceptable both to patients and to surgeons.
  
  
  CONCLUSIONS
  Rectus abdominis microvascular free-tissue transfer for repair of orbital exenteration defects is a safe and reliable alternative to the use of the temporalis or the pectoralis major muscle as a pedicle flap; it provides a larger volume of well-vascularized tissue and greater placement flexibility without associated orientation problems; and the long vascular pedicle facilitates the use of multiple donor vessels within the head and neck, which is an advantage in previously irradiated patients. Postoperative care and the donor site defect are well tolerated. The flap allows reliable obturation of the oral maxillectomy defect, and it negates the need for cavity care in these patients.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Shepherd G
authors.initials: SG
authors.lastname: Pryor
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.forename: Jan L
authors.initials: JL
authors.lastname: Kasperbauer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008833:Microcirculation; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D017233:Orbit Evisceration; D019651:Plastic Surgery Procedures / Q000379:methods*; D017568:Rectus Abdominis / Q000098:blood supply / Q000637:transplantation*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome