Effectiveness of temporal island flap pedicled with perforating branch of zygomatic orbital artery to repair the defects after periocular malignant tumor resection_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Qi ,  TANG Xiujun , WANG Haoyu , LI Feng , LONG Yan , LIU Hang , MO Xiaojin

Department of Medical Cosmetology, Guizhou Provincial People’s Hospital, Guiyang Guizhou, 550002, P. R. China;

Corresponding?author：

TANG Xiujun, Email: xiujunsszx@163.com

Keywords：

Periocular defect; zygomatic orbital artery; perforator flap; malignant tumor; wound repair

DOI：

10.7507/1002-1892.202211120

Video：

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Objective To summarize the effectiveness of the temporal island flap pedicled with the perforating branch of zygomatic orbital artery for repairing defects after periocular malignant tumor resection. Methods Between January 2015 and December 2020, 15 patients with periocular malignant tumors were treated. There were 5 males and 10 females with an average age of 62 years (range, 40-75 years). There were 12 cases of basal cell carcinoma and 3 cases of squamous carcinoma. The disease duration ranged from 5 months to 10 years (median, 2 years). The size of tumors ranged from 1.0 cm×0.8 cm to 2.5 cm×1.5 cm, without tarsal plate invasion. After extensive resection of the tumors, the left defects in size of 2.0 cm×1.5 cm to 3.5 cm×2.0 cm were repaired with the temporal island flap pedicled with the perforating branch of zygomatic orbital artery via subcutaneous tunnel. The size of the flaps ranged from 3.0 cm×1.5 cm to 5.0 cm×2.0 cm. The donor sites were separated subcutaneously and sutured directly. Results All flaps survived after operation and the wounds healed by first intention. The incisions at donor sites healed by first intention. All patients were followed up 6-24 months (median, 11 months). The flaps were not obviously bloated, the texture and color were basically the same as the surrounding normal skin, and the scars at recipient sites were not obviously. There was no complication such as ptosis, ectropion, or incomplete closure of the eyelids and recurrence of tumor during follow-up. Conclusion The temporal island flap pedicled with the perforating branch of zygomatic orbital artery can repair the defects after periorbital malignant tumors resection and has the advantages of reliable blood supply, flexible design, and good morphology and function.

Citation： ZHANG Qi, TANG Xiujun, WANG Haoyu, LI Feng, LONG Yan, LIU Hang, MO Xiaojin. Effectiveness of temporal island flap pedicled with perforating branch of zygomatic orbital artery to repair the defects after periocular malignant tumor resection. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(4): 469-472. doi: 10.7507/1002-1892.202211120 Copy

1.	Stewart CM, Tan LT, Johnson D, et al. Key issues when reconstructing extensive upper eyelid defects with description of a dynamic, frontalis turnover flap. Ophthalmic Plast Reconstr Surg, 2016, 32(4): 249-251.
2.	Chen Y, Al-Sadah Z, Kikkawa DO, et al. A modified hughes flap for correction of refractory cicatricial lower lid retraction with concomitant ectropion. Ophthalmic Plast Reconstr Surg, 2020, 36(5): 503-507.
3.	陳再洪, 聶政, 游曉波, 等. 眼輪匝肌為蒂肌皮瓣修復眼瞼皮膚缺損的效果. 中華醫學美學美容雜志, 2022, 28(2): 96-97.
4.	Bhandari PS. Reconstruction of medial canthal defects by local/loco-regional flaps. J Craniofac Surg, 2022, 33(3): e287-e290.
5.	何桂佳, 周健, 胡鵬, 等. 旋股外側動脈嵌合皮瓣修復老年患者眶周惡性腫瘤切除術后巨大缺損. 中國修復重建外科雜志, 2021, 35(11): 1505-1506.
6.	Delia G, Fazio A, Parafioriti A, et al. The propeller myocutaneous flap of the upper eyelid: Anatomical study and its clinical implication. J Craniofac Surg, 2021, 32(7): 2475-2478.
7.	張馳, 唐修俊, 王達利, 等. 風箏皮瓣在眉弓部良性腫瘤切除術后創面美容亞單位的美學修復. 中華整形外科雜志, 2017, 33(1): 12-15.
8.	Yano T, Karakawa R, Shibata T, et al. Ideal esthetic and functional full-thickness lower eyelid “like with like” reconstruction using a combined Hughes flap and swing skin flap technique. J Plast Reconstr Aesthet Surg, 2021, 74(11): 3015-3021.
9.	聶晶晶, 鄭春梅, 侯鄭丹, 等. 眼輪匝肌蒂顳部島狀皮瓣修復眼瞼分裂痣切除后缺損的效果. 中華醫學美學美容雜志, 2021, 27(2): 149-150.
10.	Wang W, Meng H, Yu S, et al. Reconstruction of giant full-thickness lower eyelid defects using a combination of palmaris longus tendon with superiorly based nasolabial skin flap and palatal mucosal graft. J Plast Surg Hand Surg, 2021, 55(3): 147-152.
11.	Wang XN, Tang YX, Guo T, et al. Subcutaneous pedicled propeller flap for reconstructing the large eyelid defect due to excision of malignancies or trauma. Sci Rep, 2022, 12(1): 4891. doi: 10.1038/s41598-022-09100-4.
12.	田明, 李小靜, 寧金龍, 等. 顴眶動脈為蒂的眶周穿支皮瓣的解剖學基礎及臨床應用研究. 中華整形外科雜志, 2019, 35(10): 973-977.
13.	Park HJ, Lee JH, Jung W. The superficial temporal artery and zygomatico-orbital artery: Superficial arterial distribution of the anterior temple area. Biomed Res Int, 2022, 2022: 3790546. doi: 10.1155/2022/3790546.
14.	Liu S, Yan W, Wang G, et al. Topographic anatomy of the zygomatico-orbital artery: Implications for improving the safety of temporal augmentation. Plast Reconstr Surg, 2021, 148(1): 19e-27e.
15.	Taylor GI, Corlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries: development of the concept and designing safe flaps. Plast Reconstr Surg, 2011, 127(4): 1447-1459.
16.	Chen B, Woo DM, Liu J, et al. Conjunctival flap with auricular cartilage grafting: a modified Hughes procedure for large full thickness upper and lower eyelid defect reconstruction. Int J Ophthalmol, 2021, 14(8): 1168-1173.
17.	Balchev G, Balabanov C, Murgova S. Glabellar flap technique in oculoplastic surgery. Indian J Ophthalmol, 2022, 70(1): 281-286.
18.	陳一衡, 池征璘, 李士, 等. 高壓氧對多個血管體供養皮支皮瓣遠端成活的效果觀察. 中華顯微外科雜志, 2017, 40(1): 88-90.

1. Stewart CM, Tan LT, Johnson D, et al. Key issues when reconstructing extensive upper eyelid defects with description of a dynamic, frontalis turnover flap. Ophthalmic Plast Reconstr Surg, 2016, 32(4): 249-251.
2. Chen Y, Al-Sadah Z, Kikkawa DO, et al. A modified hughes flap for correction of refractory cicatricial lower lid retraction with concomitant ectropion. Ophthalmic Plast Reconstr Surg, 2020, 36(5): 503-507.
3. 陳再洪, 聶政, 游曉波, 等. 眼輪匝肌為蒂肌皮瓣修復眼瞼皮膚缺損的效果. 中華醫學美學美容雜志, 2022, 28(2): 96-97.
4. Bhandari PS. Reconstruction of medial canthal defects by local/loco-regional flaps. J Craniofac Surg, 2022, 33(3): e287-e290.
5. 何桂佳, 周健, 胡鵬, 等. 旋股外側動脈嵌合皮瓣修復老年患者眶周惡性腫瘤切除術后巨大缺損. 中國修復重建外科雜志, 2021, 35(11): 1505-1506.
6. Delia G, Fazio A, Parafioriti A, et al. The propeller myocutaneous flap of the upper eyelid: Anatomical study and its clinical implication. J Craniofac Surg, 2021, 32(7): 2475-2478.
7. 張馳, 唐修俊, 王達利, 等. 風箏皮瓣在眉弓部良性腫瘤切除術后創面美容亞單位的美學修復. 中華整形外科雜志, 2017, 33(1): 12-15.
8. Yano T, Karakawa R, Shibata T, et al. Ideal esthetic and functional full-thickness lower eyelid “like with like” reconstruction using a combined Hughes flap and swing skin flap technique. J Plast Reconstr Aesthet Surg, 2021, 74(11): 3015-3021.
9. 聶晶晶, 鄭春梅, 侯鄭丹, 等. 眼輪匝肌蒂顳部島狀皮瓣修復眼瞼分裂痣切除后缺損的效果. 中華醫學美學美容雜志, 2021, 27(2): 149-150.
10. Wang W, Meng H, Yu S, et al. Reconstruction of giant full-thickness lower eyelid defects using a combination of palmaris longus tendon with superiorly based nasolabial skin flap and palatal mucosal graft. J Plast Surg Hand Surg, 2021, 55(3): 147-152.
11. Wang XN, Tang YX, Guo T, et al. Subcutaneous pedicled propeller flap for reconstructing the large eyelid defect due to excision of malignancies or trauma. Sci Rep, 2022, 12(1): 4891. doi: 10.1038/s41598-022-09100-4.
12. 田明, 李小靜, 寧金龍, 等. 顴眶動脈為蒂的眶周穿支皮瓣的解剖學基礎及臨床應用研究. 中華整形外科雜志, 2019, 35(10): 973-977.
13. Park HJ, Lee JH, Jung W. The superficial temporal artery and zygomatico-orbital artery: Superficial arterial distribution of the anterior temple area. Biomed Res Int, 2022, 2022: 3790546. doi: 10.1155/2022/3790546.
14. Liu S, Yan W, Wang G, et al. Topographic anatomy of the zygomatico-orbital artery: Implications for improving the safety of temporal augmentation. Plast Reconstr Surg, 2021, 148(1): 19e-27e.
15. Taylor GI, Corlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries: development of the concept and designing safe flaps. Plast Reconstr Surg, 2011, 127(4): 1447-1459.
16. Chen B, Woo DM, Liu J, et al. Conjunctival flap with auricular cartilage grafting: a modified Hughes procedure for large full thickness upper and lower eyelid defect reconstruction. Int J Ophthalmol, 2021, 14(8): 1168-1173.
17. Balchev G, Balabanov C, Murgova S. Glabellar flap technique in oculoplastic surgery. Indian J Ophthalmol, 2022, 70(1): 281-286.
18. 陳一衡, 池征璘, 李士, 等. 高壓氧對多個血管體供養皮支皮瓣遠端成活的效果觀察. 中華顯微外科雜志, 2017, 40(1): 88-90.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of temporal island flap pedicled with perforating branch of zygomatic orbital artery to repair the defects after periocular malignant tumor resection

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