Cheek rotation flap reconstruction--an anthropometric appraisal of surgical outcomes.
OBJECTIVE
Cheek rotation flaps are an established surgical procedure for coverage of facial skin defects especially of the cheek and infraorbital region. A comparison of pre- and postoperative anthropometric measurements may help to objectify intraoperative estimations with regards to postoperative appearance.


METHODS
We present an evaluation of 31 patients undergoing periorbital reconstruction by a cheek rotation flap on standardized photographs based on reference anthropometric data. Analysis included intercanthal, binocular and eye fissure width, eye fissure, lid sulcus and upper lid height, upper and lower iris coverage, position of cornea to palpebra inferior, scleral show, ectropion, and canthal tilt. Furthermore, it was clearly differentiated whether the defect to cover included eyelid skin or not.


RESULTS
Ectropion showed a significant association to surgery (p = 0.03) and time (p = 0.03). If the defect to cover included lower eyelid skin, lower iris coverage values decreased significantly (p = 0.02), meanwhile the rate of scleral show increased significantly (p < 0.01), indicating pre- to postoperative lower eyelid retraction.


CONCLUSIONS
In all patients analyzed, indices were reproducible and reliable. An association between surgery and ectropion was detectable. Whenever lower eyelid skin is involved in the defect to be covered, the significantly decreased lower iris coverage and increased rate of scleral show indicate an increased risk of lower lid retraction.


CONCLUSIONS
Whenever eyelid skin is involved in a defect to be covered by a cheek rotation flap, there is an increased risk of postoperative lower lid distortion. Special care has to be taken to perform techniques preventing lower lid retraction.
Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany. raschke.gregor@googlemail.com.|Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany. raschke.gregor@googlemail.com.
Gregor F
GF
Raschke
Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, Markus Krankenhaus, Academic Teaching Hospital, Johann Wolfgang von Goethe University, Wilhelm-Epstein-Straße 4, Frankfurt am Main, Germany.|Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Ulrich M
UM
Rieger
Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Rolf-Dieter
RD
Bader
Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Arndt
A
Guentsch
Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Oliver
O
Schaefer
Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Stefan
S
Elstner
Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
Stefan
S
Schultze-Mosgau
D002610:Cheek / Q000601:surgery*; D006801:Humans; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps