title: Composite orbital reconstruction using the vascularized segmentalized osteo-fascio-cutaneous fibula flap.
abstract: Reconstruction of composite orbital defects must address the orbit and an exposed skull base and/or maxillary region. The orbit should not only be covered but also reshaped to accommodate the orbital contents or an epithesis when warranted. This study presents a rationale for a near-anatomical reconstruction of the orbit, together with adjacent dead space obliteration, using the segmentalized osteo-fascia-cutaneous fibula flap. Before the flap transfer, a cutting template for the fibula is made according to the measures and requirements of the facial defect. The segmentalized bone is then osteosynthesized to the facial skeleton and revascularized. Thus, an orbital depth is created by the bony fibula, whereas the fascio-cutaneous part of the flap may be used for lining the orbit and obliteration of the skull base or the maxillary region, or resurface the palate and/or the nasal cavity.
authors.affiliation: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: T Kalle
authors.initials: TK
authors.lastname: Lundgren
authors.affiliation: Department of Plastic and Reconstructive Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pignatti
authors.affiliation: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Halle
authors.affiliation: Department of Plastic and Reconstructive Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Boscaini
authors.affiliation: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Ann-Charlotte Docherty
authors.initials: AC
authors.lastname: Skogh
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Modena University Hospital, Policlinico di Modena, Italy.
authors.forename: Chiarini
authors.initials: C
authors.lastname: Luigi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy. Electronic address: desantis.giorgio@unimore.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Santis
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D009915:Orbit / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Craniofacial surgery; Orbital reconstruction; microsurgery; skull base reconstruction