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. 2022 Jul 13;10(7):e4419.
doi: 10.1097/GOX.0000000000004419. eCollection 2022 Jul.

Medial Canthus Reconstruction with the Paramedian Forehead Flap

Rohun Gupta  1 , Jithin John  1 , Justin Hart  2 , Kongkrit Chaiyasate  1   2
Affiliations

Medial Canthus Reconstruction with the Paramedian Forehead Flap

Rohun Gupta et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: The medial canthus represents the medial confluence of the upper and lower eyelid margins and plays an integral role in the lacrimal duct system. Various flaps have been utilized for the reconstruction of the lower eyelid in the medial canthal region. Our institution primarily utilizes the paramedian forehead flap for the reconstruction of medial canthus defects. Our study looked to evaluate the work of a single plastic surgeon and identify their postoperative outcomes.

Methods: A retrospective chart review was conducted at Beaumont Health System, Royal Oak, for patients who underwent medial canthal repair by the lead surgeon between the years 2014 and 2018. Demographic data, operative details, complications, medical comorbidities, and patient outcomes were retrospectively gathered and analyzed.

Results: A total of five patients were isolated. Patients underwent paramedian forehead flap medial canthal repair by the lead surgeon and were found to tolerate the procedure well. All patients had clinically viable flaps with aesthetically pleasing results.

Conclusions: Utilization of the paramedian forehead flap leads to successful medial canthal repair with adequate coverage. Although the paramedian forehead flap requires three stages to complete, the procedure leaves patients with aesthetically pleasing results. In addition, the paramedian forehead flap has limited cases of ectropion. With the right expertise and patient population, the paramedian forehead flap can be highly successful in the repair of medial canthal defects.

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Figures

Fig. 1.
Fig. 1.
Case 1: preoperative view of a patient with a defect in her right medial canthal region.
Fig. 2.
Fig. 2.
Case 1: 1-week follow-up after first-stage paramedian forehead flap reconstruction of the right medial canthal region.
Fig. 3.
Fig. 3.
Case 1: postoperative photograph at 12-month follow-up.
Fig. 4.
Fig. 4.
Case 2: preoperative view of a patient with a defect in her left medial canthal region.
Fig. 5.
Fig. 5.
Case 2: 1-week follow-up after rotation forehead flap reconstruction of the left medial canthal region.
Fig. 6.
Fig. 6.
Case 2: postoperative photograph at 12-month follow-up.
Fig. 7.
Fig. 7.
Case 3: preoperative view of a patient with a defect in his right medial canthal region.
Fig. 8.
Fig. 8.
Case 3: 1-week follow-up after left-sided forehead flap reconstruction of the right medial canthal region.
Fig. 9.
Fig. 9.
Case 3: postoperative photograph at 12-month follow-up.
Fig. 10.
Fig. 10.
Case 4: preoperative view of a patient with a defect in his right medial canthal region.
Fig. 11.
Fig. 11.
Case 4: 1-week follow-up after left-sided forehead flap reconstruction of the right medial canthal region.
Fig. 12.
Fig. 12.
Case 4: postoperative photograph at 12-month follow-up.
Fig. 13.
Fig. 13.
Case 5: preoperative view of a patient with a defect in her left medial canthal region.
Fig. 14.
Fig. 14.
Case 5: 4-week follow-up after forehead flap reconstruction with immediate canthoplasty for left-sided medial canthal defect.
Fig. 15.
Fig. 15.
Case 5: postoperative photograph at 12-month follow-up.
See this image and copyright information in PMC

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