Semin Plast Surg 2019; 33(02): 125-131
DOI: 10.1055/s-0039-1685480
DOI: 10.1055/s-0039-1685480
Review Article
Soft Tissue Microvascular Reconstruction of Orbital Exenteration Defects
Further Information
Publication History
Publication Date:
26 April 2019 (online)
Abstract
The main goal of head and neck reconstruction is the restoration of form and function. Oncologic surgery makes this process more complex, as the preplanned defect can be very different from its intraoperative counterpart. This emphasizes the role of preoperative planning and a diverse reconstructive “tool box” that can accommodate a variety of complicated defects. The other reconstructive goals are determined by the patient with the aid of an interdisciplinary team. While multiple local and regional reconstructive options are available, free tissue transfer provides a versatile and reliable option for reconstruction—especially for complex orbital defects. Here the authors discuss free soft tissue transfer options for orbital exenteration. This review will catalog the advantages and disadvantages of the radial forearm, rectus abdominis, latissimus, and anterolateral thigh.
References
- 1 Kesting MR, Koerdt S, Rommel N. , et al. Classification of orbital exenteration and reconstruction. J Craniomaxillofac Surg 2017; 45 (04) 467-473
- 2 Parkes WJ, Krein H, Heffelfinger R, Curry J. Use of the anterolateral thigh in cranio-orbitofacial reconstruction. Plast Surg Int 2011; 2011: 941742
- 3 López F, Suárez C, Carnero S, Martín C, Camporro D, Llorente JL. Free flaps in orbital exenteration: a safe and effective method for reconstruction. Eur Arch Otorhinolaryngol 2013; 270 (06) 1947-1952
- 4 Rapidis AD, Liarikos S. Malignant orbital and orbitomaxillary tumors: surgical considerations. Orbit 1998; 17 (02) 77-88
- 5 Moyer JS, Chepeha DB, Prince ME, Teknos TN. Microvascular reconstruction of the orbital complex. Facial Plast Surg Clin North Am 2009; 17 (02) 225-237
- 6 Pryor SG, Moore EJ, Kasperbauer JL. Orbital exenteration reconstruction with rectus abdominis microvascular free flap. Laryngoscope 2005; 115 (11) 1912-1916
- 7 Sasaki CT, Ariyan S, Spencer D, Buckwalter J. Pectoralis major myocutaneous reconstruction of the anterior skull base. Laryngoscope 1985; 95 (02) 162-166
- 8 Simsek T, Engin MS, Yildirim K, Kodalak EA, Demir A. Reconstruction of extensive orbital exenteration defects using an anterolateral thigh/vastus lateralis chimeric flap. J Craniofac Surg 2017; 28 (03) 638-642
- 9 Rabey N, Abood A, Gillespie P, Athanassoglou V, Rene C, Malata CM. Reconstruction of complex orbital exenteration defects: a single center's experience with a five-year follow-up. Ann Plast Surg 2014; 73 (02) 158-163
- 10 Taylan G, Yildirim S, Aköz T. Reconstruction of large orbital exenteration defects after resection of periorbital tumors of advanced stage. J Reconstr Microsurg 2006; 22 (08) 583-589
- 11 Kwon D, Iloreta A, Miles B, Inman J. Open anterior skull base reconstruction: a contemporary review. Semin Plast Surg 2017; 31 (04) 189-196
- 12 Browne JD, Burke AJ. Benefits of routine maxillectomy and orbital reconstruction with the rectus abdominis free flap. Otolaryngol Head Neck Surg 1999; 121 (03) 203-209
- 13 Jones NF, Johnson JT, Shestak KC, Myers EN, Swartz WM. Microsurgical reconstruction of the head and neck: interdisciplinary collaboration between head and neck surgeons and plastic surgeons in 305 cases. Ann Plast Surg 1996; 36 (01) 37-43
- 14 Savage RC. Orbital exenteration and reconstruction for massive basal cell and squamous cell carcinoma of cutaneous origin. Ann Plast Surg 1983; 10 (06) 458-466
- 15 Bartley GB, Garrity JA, Waller RR, Henderson JW, Ilstrup DM. Orbital exenteration at the Mayo Clinic. 1967–1986. Ophthalmology 1989; 96 (04) 468-473
- 16 Hanasono MM, Lee JC, Yang JS, Skoracki RJ, Reece GP, Esmaeli B. An algorithmic approach to reconstructive surgery and prosthetic rehabilitation after orbital exenteration. Plast Reconstr Surg 2009; 123 (01) 98-105
- 17 Gliklich RE, Rounds MF, Cheney ML, Varvares MA. Combining free flap reconstruction and craniofacial prosthetic technique for orbit, scalp, and temporal defects. Laryngoscope 1998; 108 (4, Pt 1): 482-487
- 18 Chepeha DB, Wang SJ, Marentette LJ. , et al. Restoration of the orbital aesthetic subunit in complex midface defects. Laryngoscope 2004; 114 (10) 1706-1713
- 19 Chana JS, Wei FC. A review of the advantages of the anterolateral thigh flap in head and neck reconstruction. Br J Plast Surg 2004; 57 (07) 603-609
- 20 Cherubino M, Turri-Zanoni M, Battaglia P. , et al. Chimeric anterolateral thigh free flap for reconstruction of complex cranio-orbito-facial defects after skull base cancers resection. J Craniomaxillofac Surg 2017; 45 (01) 87-92
- 21 Olsen KD, Meland NB, Ebersold MJ, Bartley GB, Garrity JA. Extensive defects of the sino-orbital region. Results with microvascular reconstruction. Arch Otolaryngol Head Neck Surg 1992; 118 (08) 828-833 , discussion 859–860
- 22 Baker SR. Closure of large orbital-maxillary defects with free latissimus dorsi myocutaneous flaps. Head Neck Surg 1984; 6 (04) 828-835
- 23 Piantanida R, Roselli R, Pellini R, Ferrario F, Boschini P, Spriano G. Reconstruction of major orbital-maxillary defects with free latissimus dorsi myocutaneous flap. Facial Plast Surg 1999; 15 (04) 297-302
- 24 Triana Jr RJ, Uglesic V, Virag M. , et al. Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. Arch Facial Plast Surg 2000; 2 (02) 91-101
- 25 Cordeiro PG, Santamaria E. A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg 2000; 105 (07) 2331-2346 , discussion 2347–2348
- 26 Santamaria E, Cordeiro PG. Reconstruction of maxillectomy and midfacial defects with free tissue transfer. J Surg Oncol 2006; 94 (06) 522-531
- 27 Urken ML. , MLC, Sullivan MJ, Biller HF. Atlas of Regional and Free Flaps for Head and Neck Reconstruction. New York, NY: Raven Press; 1994
- 28 Yang G, Chen B, Gao Y. Free transfer of forearm flap. Report of 56 cases. National Med J China 1981; 61 (03) 139-142
- 29 Evans HB, Lampe HB. The radial forearm flap in head and neck reconstruction. J Otolaryngol 1987; 16 (06) 382-386
- 30 Santamaria E, Granados M, Barrera-Franco JL. Radial forearm free tissue transfer for head and neck reconstruction: versatility and reliability of a single donor site. Microsurgery 2000; 20 (04) 195-201
- 31 Yokoo S, Komori T, Furudoi S. , et al. Three-dimensional reconstruction after oral oncologic surgery using single free radial forearm flaps or free rectus abdominis musculocutaneous flaps. J Oral Sci 2004; 46 (01) 65-70
- 32 Seikaly H, Rieger J, O'Connell D, Ansari K, Alqahtani K, Harris J. Beavertail modification of the radial forearm free flap in base of tongue reconstruction: technique and functional outcomes. Head Neck 2009; 31 (02) 213-219
- 33 Gonzalez-Castro J, Petrisor D, Ballard D, Wax MK. The double-barreled radial forearm osteocutaneous free flap. Laryngoscope 2016; 126 (02) 340-344
- 34 Meland NB, Fisher J, Irons GB, Wood MB, Cooney WP. Experience with 80 rectus abdominis free-tissue transfers. Plast Reconstr Surg 1989; 83 (03) 481-487
- 35 Urken ML, Turk JB, Weinberg H, Vickery C, Biller HF. The rectus abdominis free flap in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1991; 117 (09) 1031
- 36 Nakatsuka T, Harii K, Yamada A, Asato H, Ebihara S. Versatility of a free inferior rectus abdominis flap for head and neck reconstruction: analysis of 200 cases. Plast Reconstr Surg 1994; 93 (04) 762-769
- 37 Uusitalo M, Ibarra M, Fulton L. , et al. Reconstruction with rectus abdominis myocutaneous free flap after orbital exenteration in children. Arch Ophthalmol 2001; 119 (11) 1705-1709
- 38 Slavin SA, Goldwyn RM. The midabdominal rectus abdominis myocutaneous flap: review of 236 flaps. Plast Reconstr Surg 1988; 81 (02) 189-199
- 39 Civantos FJ. Latissimus dorsi microvascular flap. Facial Plast Surg 1996; 12 (01) 65-68
- 40 Maxwell GP, Stueber K, Hoopes JE. A free latissimus dorsi myocutaneous flap: case report. Plast Reconstr Surg 1978; 62 (03) 462-466
- 41 Barrow DL, Nahai F, Fleischer AS. Use of free latissimus dorsi musculocutaneous flaps in various neurosurgical disorders. J Neurosurg 1983; 58 (02) 252-258
- 42 Shestak KC, Schusterman MA, Jones NF, Johnson JT. Immediate microvascular reconstruction of combined palatal and midfacial defects using soft tissue only. Microsurgery 1988; 9 (02) 128-131
- 43 Bartlett SP, May Jr JW, Yaremchuk MJ. The latissimus dorsi muscle: a fresh cadaver study of the primary neurovascular pedicle. Plast Reconstr Surg 1981; 67 (05) 631-636
- 44 Tobin GR, Schusterman M, Peterson GH, Nichols G, Bland KI. The intramuscular neurovascular anatomy of the latissimus dorsi muscle: the basis for splitting the flap. Plast Reconstr Surg 1981; 67 (05) 637-641
- 45 Baudet J, Guimberteau JC, Nascimento E. Successful clinical transfer of two free thoraco-dorsal axillary flaps. Plast Reconstr Surg 1976; 58 (06) 680-688
- 46 Kosutic D, Uglesic V, Knezevic P, Milenovic A, Virag M. Latissimus dorsi-scapula free flap for reconstruction of defects following radical maxillectomy with orbital exenteration. J Plast Reconstr Aesthet Surg 2008; 61 (06) 620-627
- 47 Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984; 37 (02) 149-159
- 48 Joo YH, Cho KJ, Park JO, Kim MS. Usefulness of the anterolateral thigh flap with vascularized fascia lata for reconstruction of orbital floor and nasal surface after total maxillectomy. Laryngoscope 2013; 123 (09) 2125-2130
- 49 Hynes SL, Forrest CR, Borschel GH. Use of the anterolateral thigh flap for reconstruction of the pediatric anophthalmic orbit. J Plast Reconstr Aesthet Surg 2016; 69 (01) 84-90