title: Use of the anterolateral thigh flap for reconstruction of the pediatric anophthalmic orbit.
abstract: Children with acquired anophthalmia pose unique reconstructive challenges. With implant-based reconstruction, the current standard of care, there is a tendency toward intraorbital and adnexal tissue contraction and an increasing volume discrepancy with orbital growth, resulting in enophthalmos and eyelid retraction, and also difficulty in retaining an ocular prosthesis. We describe a novel technique for secondary reconstruction of the pediatric anophthalmic orbit using a small free anterolateral thigh (ALT) flap. The technique involves release of retracted eyelids and restoration of orbital volume with an ALT flap based on the superficial temporal vessels. The purpose of this study is to detail the results of treatment of a series of four consecutive patients with unilateral acquired anophthalmia managed with ALT flaps. Improved symmetry, successful retention of an ocular prosthesis, and patient satisfaction were achieved in all cases.
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
authors.forename: Sally L
authors.initials: SL
authors.lastname: Hynes
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Forrest
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address: gregory.borschel@sickkids.ca.
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Borschel
mesh_terms: D000293:Adolescent; D000853:Anophthalmos / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005137:Eye, Artificial; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009915:Orbit / Q000601:surgery*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh / Q000601:surgery*; D016896:Treatment Outcome
keywords: Anophthalmia; Anophthalmic orbit; Anterolateral thigh flap; Free tissue transfer