Usefulness of the orbicularis oculi myocutaneous flap in periorbital reconstruction

다국어 초록 (Multilingual Abstract)

Background: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences.
Methods: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications.
Results: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft.
Conclusion: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.

참고문헌 (Reference)

1 배용찬, "비중격 연골-점막 복합조직이식과 상안검 피판을 이용한 하안검의 재건" 대한성형외과학회 31 (31): 309-314, 2004

2 Maghsodnia G., "Using bipedicled myocutaneous Tripier flap to correct ectropion after excision of lower eyelid basal cell carcinoma" 22 : 606-608, 2011

3 Moschella F., "Upper eyelid reconstruction with mucosa-lined bipedicled myocutaneous flaps" 48 : 294-299, 1995

4 Porfiris E., "Upper eyelid island orbicularis oculi myocutaneous flap for periorbital reconstruction" 16 : 42-44, 2000

5 d’Alcontres FS., "The orbicularis oculi muscle flap: its use for treatment of lagophthalmos and a review of its use for other applications" 63 : 416-422, 2010

6 Kersten RC., "Tarsal rotational flap for upper eyelid reconstruction" 104 : 918-922, 1986

7 Tirone L., "Reconstruction of lower eyelid and periorbital district: an orbicularis oculi myocutaneous flap" 62 : 1384-1388, 2009

8 Kim SW., "Orbicularis oculi myocutaneous island flap for upper eyelid reconstruction" 23 : 746-748, 2012

9 Demir Z., "Orbicularis oculi myocutaneous advancement flap for upper eyelid reconstruction" 121 : 443-450, 2008

10 한지현, "Medial and Lateral Canthal Reconstruction with an Orbicularis Oculi Myocutaneous Island Flap" 대한성형외과학회 42 (42): 40-45, 2015

11 Greco M., "A new technique of upper eyelid blepharoplasty using the orbicularis muscle flap" 36 : 18-22, 2012