Application of the external-pedicled and inferior-pedicled cheek rotation flaps in the reconstruction of skin defects at the medial and lateral canthi of the lower eyelid

Tóm tắt

the inferior-pedicled cheek rotation flap in reconstructing skin defects of the lower eyelid, particularly at the medial and lateral canthal regions - areas that present significant reconstructive and aesthetic challenges.
Subjectsand methods: A case series of patients with lower-eyelid skin defects following tumor excision, trauma, or burn injury. Defects ranged from 1-3 cm and involved the medial or lateral canthus without full-thickness eyelid loss. Reconstruction was performed using either a lateral-pedicled cheek rotation flap based on branches of the facial artery or an inferior-pedicled cheek rotation flap based on the angular arterial system. Outcomes assessed included flap survival, eyelid position, contour, complications, and aesthetic satisfaction over a 1-3-month follow-up.
Results: All flaps survived completely with good color and thickness match to the lower-eyelid region. No cases of ectropion, lid retraction, or flap necrosis occurred. Scars were well concealed within natural facial creases. Functional and aesthetic outcomes were rated as good to excellent in all patients.
Conclusion: Lateral- and inferior-pedicled cheek rotation flaps provide a reliable, simple, and aesthetically favorable option for reconstructing lower-eyelid skin defects involving both the medial and lateral canthi. Their robust vascularity, tissue match, and minimal risk of eyelid distortion make them an effective method for periocular reconstruction.