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.	陈再洪, 聂政, 游晓波, 等. 眼轮匝肌为蒂肌皮瓣修复眼睑皮肤缺损的效果. 中华医学美学美容杂志, 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, 胡鹏, 等. 旋股外侧动脉嵌合皮瓣修复老年患者眶周恶性肿瘤切除术后巨大缺损. 中国修复重建外科杂志, 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.	张驰, 唐修俊, 王达利, 等. 风筝皮瓣在眉弓部良性肿瘤切除术后创面美容亚单位的美学修复. 中华整形外科杂志, 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.	聂晶晶, 郑春梅, 侯郑丹, 等. 眼轮匝肌蒂颞部岛状皮瓣修复眼睑分裂痣切除后缺损的效果. 中华医学美学美容杂志, 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, 李小静, 宁金龙, 等. 颧眶动脉为蒂的眶周穿支皮瓣的解剖学基础及临床应用研究. 中华整形外科杂志, 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.	陈一衡, 池征璘, 李士, 等. 高压氧对多个血管体供养皮支皮瓣远端成活的效果观察. 中华显微外科杂志, 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. 陈再洪, 聂政, 游晓波, 等. 眼轮匝肌为蒂肌皮瓣修复眼睑皮肤缺损的效果. 中华医学美学美容杂志, 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, 胡鹏, 等. 旋股外侧动脉嵌合皮瓣修复老年患者眶周恶性肿瘤切除术后巨大缺损. 中国修复重建外科杂志, 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. 张驰, 唐修俊, 王达利, 等. 风筝皮瓣在眉弓部良性肿瘤切除术后创面美容亚单位的美学修复. 中华整形外科杂志, 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. 聂晶晶, 郑春梅, 侯郑丹, 等. 眼轮匝肌蒂颞部岛状皮瓣修复眼睑分裂痣切除后缺损的效果. 中华医学美学美容杂志, 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, 李小静, 宁金龙, 等. 颧眶动脉为蒂的眶周穿支皮瓣的解剖学基础及临床应用研究. 中华整形外科杂志, 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. 陈一衡, 池征璘, 李士, 等. 高压氧对多个血管体供养皮支皮瓣远端成活的效果观察. 中华显微外科杂志, 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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