Use of Modified Islanded Paramedian Forehead Flap for Complex Periocular Facial Reconstruction

摘要

The paramedian forehead flap is a workhorse flap for reconstructing the nose and periorbital regions. Many variants are described including an islanded flap. However, eyebrow reconstruction is not usually performed with these flaps. The authors describe a patient suffering from postburn scarring medial to the left eye, including loss of the left eyebrow. He underwent a single-stage transfer of the paramedian forehead flap. The flap incorporated scalp hair, which restored the missing eyebrow hair after transfer. The donor defect closed primarily. The paramedian forehead flap is amenable to customization by including a segment of hair-bearing scalp to concomitantly reconstruct the nasal dorsum and eyebrow. affected by scar would have entailed the use of a combination of flaps, with or without skin grafts. Another solution would be to improve each affected facial component in a staged fashion with multiple surgeries. The patient was an electrician, employed on a daily wages basis. He could scarcely afford the time and cost involved in multiple visits to the operation theater. Therefore, a novel flap was used to address the entire defect in a single stage. A flap to reconstruct his nose, anatomically based on the paramedian forehead flap, was judiciously modified to include a segment of hair-bearing scalp to concomitantly reconstruct the eyebrow.