Medial Canthal Reconstruction with Glabellar Combined Rintala Flaps

Abstract

This technique can be performed readily and is applicable to the reconstruction of relatively large defects and is also aesthetically excellent because of a postoperative suture line that is consistent with the topographic curve. This technique may be useful for medial canthal reconstruction.

The figure-of-eight radix nasi flap for medial canthal defects

“…These include the upper eyelid myocutaneous flap, the glabellar flap and its modifications, the rhomboid flap, the forehead flap, the bilobed flap, the VeY advancement flap and the pericranial flap (Sullivan and Bray, 1995;Moretti and Gomez Garcia, 1998;Ng et al, 2001;Yildirim et al, 2001;Tezel et al, 2002;Stagno d'Alcontres et al, 2004;Bertelmann et al, 2006;Leatherbarrow et al, 2006;Onishi et al, Classic forehead flaps require a two-stage operation and subsequent defatting procedures. Reconstruction of the medial canthus using a forehead flap with subcutaneous pedicle can be done in a one-stage operation, but this option is bulky because of the pedicle's path beneath the skin layer (Kars xdag et al, 2008).…”

“…used the modified glabellar flap in their series. However, with their technique a second-stage operation was necessary to resect the pedicle Onishi et al (2007). used the Rintala flap to cover the glabellar flap donor site in their method of medial canthal reconstruction.…”

Defect closure in the paranasal region: an enduring challenge

“…Even so, some authors favor skin grafts 18 due to the above-mentioned advantages, especially in cases of superficial defects. Numerous authors, [3][4][5][6][7][13][14][15]19 however, report that flaps surpass the results of skin grafts in paranasal reconstruction due to a better color and skin texture match, justifying the greater effort involved in flaps. We are of the opinion that flap coverage should not be restricted to defects with an insufficient transplant bed, where flap coverage is unavoidable.…”

“…8 The vascular anatomy of the paranasal and adjacent regions that qualify for a flap donor site has been studied extensively. 1,[9][10][11][12] The main arteries are the angular artery, 13,14 fed by the external carotid artery, and the supratrochlear and supraorbital arteries, 15 both arising from the internal carotid artery (Fig. 1b).…”

A novel technique for full thickness medial canthal reconstruction; playing with broken lines

“…Reconstruction of the posterior lamella can be performed by harvesting the buccal mucosa and hard palate graft; however, it is not a good choice in cases with a small and deeply-sited medial canthal area, especially when the medial canthal tendon reconstruction is also mandatory. For reconstruction of anterior lamella, various types of skin flaps have been introduced previously, and rhomboid flap technique is one of the mostly used techniques 1, 2, 3, 4, 5. The defects smaller than 1 cm 2 can be filled with a single rhomboid flap, but in larger defects, more flaps should be prepared.…”