The rhomboid flap in medial canthal reconstruction

Ng, Stephen G J; Inkster, Clare; Leatherbarrow, Brian

doi:10.1136/bjo.85.5.556

Cited by 58 publications

(49 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Persistent scars are traditionally treated either with a Z-, W-or a V-to-Y-plasty [1]. Rhomboid and bilobed flaps have also been described [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

Case of Bilateral Iatrogenic Medial Canthal Webbing Treated with Full Thickness Skin Grafts

Chiti-Batelli¹,

Grammatopoulou²

2016

JOENTR

View full text Add to dashboard Cite

A 37-year-old female sustained a domestic facial injury after falling from the stairs. The deep horizontal skin laceration that resulted from the trauma extended over the nasal dorsum, approximately 5mm from each medial canthus. The cutaneous defect was debrided from the crushed nonviable tissue and sutured by a junior doctor in the Accident and Emergency Department. Unfortunately the wound contracted over the following two weeks and the patient presented again to the hospital lamenting a clear cosmetic iatrogenic webbing deformity over the medial canthi. Two months later she was reassessed in order to allow some more time for scar maturation and to plan the surgical treatment (Figure 1,2A&2B). Ideally, it would have been preferable to delay the operation for a longer period of time, but the intense emotional distress experienced by the patient in view of the approaching wedding day, scheduled for the following month, weakened our resistance and it was agreed to proceed with the operation within the next few days.It was felt that the scars were too close to the medial canthi for a Z-or V-to-Y-plasty and an alternative, although uncharted solution for the specific defect was chosen. Two FTSG were harvested under general anesthesia from the left post-auricular matching colored area. The scars were released with a horizontal incision of approximately 7mm and the skin undermined ( Figure 3A&3B). The fat was carefully removed from both grafts and they were fashioned to match the defects and then sutured and secured with cotton bolsters in the usual manner. Fortunately the procedure was successful (Figure 4,5A&5B) and almost more importantly warded off the cancelling of the wedding. AbstractEpicanthal webbing can result from both traumatic and iatrogenic injuries. The latter is usually related to skin incisions required to gain external access to the ethmoidal and frontal sinuses or more rarely to the lacrimal sac. Surgical management traditionally involves a Z-plasty or V-to-Y plasty of the medial canthus to increase the length of the vertical scar, thus releasing the web contraction.These methods, however, may present challenging limitations when the webbing is too close to the medial canthus, since the potential length of one of the plasty limb is greatly restricted by the vicinity of the eye. This case report exemplifies such a scenario, which required an alternative solution with full thickness skin grafts (FTSG).Keywords: Medial canthus; Webbing; Full thickness skin grafts

show abstract

“…Persistent scars are traditionally treated either with a Z-, W-or a V-to-Y-plasty [1]. Rhomboid and bilobed flaps have also been described [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

Case of Bilateral Iatrogenic Medial Canthal Webbing Treated with Full Thickness Skin Grafts

Chiti-Batelli¹,

Grammatopoulou²

2016

JOENTR

View full text Add to dashboard Cite

show abstract

“…However, reconstruction of large deep defects extending to the side of the nose, and/or the upper/lower eyelid, especially in the presence of periosteal or bone infiltration, may prove very difficult. This is because: first, the medial canthus consists of multiple, individual anatomical aesthetic units that differ in soft tissue quality, thickness and contour; and second, the normal concavity without webbing or distortion of the surrounding tissues should be maintained for reproduction of the natural appearance of the medial canthal area [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“Pickaxe” Double Flap: A Useful “Tool” for Reconstruction of Deep Large Medial Canthal Defects—5-Year Experience and Brief Literature Review

Lykoudis

Alexiou

2015

Aesth Plast Surg

View full text Add to dashboard Cite

show abstract

“…Being a fundamental element of the 'facial triangle' -the socially important area bounded by the eyes, nose and mouth (3) -aesthetics are particularly important, with canthal webs being especially noticeable. Previous authors have described both individual and combination flaps (1,(4)(5)(6), with the occasional classification and management algorithm emerging from larger experience to guide the surgeon (2). Our case describes the use of a combination of flaps based on the fundamental plastic surgical principle of like-for-like replacement.…”

mentioning

confidence: 98%

“…French title -French abstract provided RÉSUMÉ : T he medial canthal region is a common site for tumours, particularly basal cell carcinomata (BCC) (1,2). Due to its location, there are certain important features concerning both function and aesthetics.…”

mentioning

confidence: 99%