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. 2014 Jan;4(1):45-50.
doi: 10.4103/2231-0746.133077.

Reconstruction of periorbital region defects: A retrospective study

Serdar Yüce  1 , Zühtü Demir  2 , Caferi Tayyar Selçuk  3 , Selim Celebioğlu  2
Affiliations

Reconstruction of periorbital region defects: A retrospective study

Serdar Yüce et al. Ann Maxillofac Surg. 2014 Jan.

Abstract

Background: Although the periorbital region forms less than 1% of the total body surface, it has a very complex anatomy; therefore, it requires a detailed approach. In this work, we aim to present the clinical applications and related literature for the algorithm of the technique which will be applied, according to the location of the defect, in choosing the surgery treatment method. Factors affecting the results and different treatment methods of the anatomical region, including its difficult reconstruction, will also be included.

Materials and methods: A review of 177 periorbital region defect reconstructions was performed.

Results: As a treatment method, in 76 (43%) patients primary closure was chosen, 39 (22%) patients had grafts and in 62 (35%) patients a flap was chosen as a treatment alternative. With respect to postoperative complications, there were a total of 6 (3.38%) patients observed with venous congestion. In 11 (6.21%) patients ectropion developed, in 1 (0.56%) patient minimal space between the eyelids while monitoring recovery was observed and in 1 (0.56%) patient, flap loss was observed due to a circulatory disorder.

Conclusions: The aim of reconstruction is to repair the defect suitable to normal physiological and anatomical values. As a result, before the surgical treatments in this difficult anatomical region, the defect width and anatomical localization must be evaluated. The most suitable reconstruction method must be identified, using an evaluation of the algorithm and the required functional and esthetical results can be obtained with intraoperative flexible behavior and a change of method, when necessary.

Keywords: Algorithm; periorbital defects; reconstruction.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Preoperative appearance of the tumoral lesion in the left upper eyelid, (b) Appearance of the planning after excision, (c) Appearance of the split thickness upper eyelid defect after excision and harvested orbicularis oculi myocutaneous V-Y advancement flap, (d) Postoperative appearance of the normal closure of the eyelid
Figure 2
Figure 2
(a) Preoperative appearance of the tumoral lesion in the right lower eyelid, (b) Appearance of the split thickness lower eyelid defect, after excision, and harvested Mustarde cheek rotation flap, (c) Postoperative appearance of the early result, (d) Postoperative appearance of the late result
Figure 3
Figure 3
(a) Preoperative appearance of the tumoral lesion in the right lower eyelid, (b) Appearance of the preoperative two-different planing, (c) Appearance of the full thickness lower eyelid defect, after excision, and harvested superficial temporal artery frontal branch based island flap, (d) Postoperative appearance of the early result
Figure 4
Figure 4
(a) Preoperative anterior appearance of the tumoral lesion in the right medial canthal region, (b) Preoperative oblique appearance of the tumoral lesion in the right medial canthal region, (c) Postoperative appearance of the early result of the glabellar flap, (d) Postoperative appearance of the late result of the glabellar flap
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