title: Supratrochlear artery island paramedian forehead flap for reconstructing the exenterated patient.
abstract: Orbital exenteration may be needed for surgical extirpation of advanced squamous or basal carcinoma of the eye or ocular adnexa. Many surgeons prefer to allow the exenterated socket granulate by secondary intention. This leads to morbidity and can be very disturbing for the patient. Moreover, it delays the delivery of adjunctive radiation often required in these individuals. We suggest a 1-stage operation that can be undertaken at the time of exenteration or as a delayed procedure to reconstruct the orbit and ensure rapid wound healing and patient rehabilitation. There is minimal donor site morbidity. A total of 5 exenterated orbits have been reconstructed by a new technique utilizing islanded median forehead flap based upon ipsilateral supratrochlear vessels. The donor site could be closed primarily in all patients. The healing was uneventful; the median hospital stay was 3 days. Although there is inevitable scarring of the forehead, this improves considerably over a period of time and does not appear to cause undue aesthetic concerns among our patients. Thus an islandised ipsilateral paramedian forehead flap based upon supratrochlear vessels is another option to close an exenteration defect.
authors.affiliation: Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsharmark@yahoo.com
authors.forename: Ramesh Kumar
authors.initials: RK
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000098:blood supply* / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D017233:Orbit Evisceration / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*