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Surgical Pearls
August 18, 2016

Combination Lateral Rotational and Glabellar Flaps for Medial Canthal Defects

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinic, Iowa City

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Facial Plast Surg. Published online August 18, 2016. doi:10.1001/jamafacial.2016.1026

Reconstruction of the medial canthal area remains challenging owing to its concave contour and convergence of skin units with variable thickness, texture, and mobility. The depth, size, and location of medial canthal defects dictate reconstructive strategy. Existing reconstructive strategies include direct closure, spontaneous granulation, free skin grafts, and various flaps.17 When deeper defects straddle the medial canthal tendon, reconstructive options are limited owing to the inadequacy of a skin graft to restore volume and the inability of a single flap to cover the defect aesthetically. This is a retrospective review of 18 patients who underwent a combination of glabellar and lateral rotational flaps for reconstruction of deep, medial canthal defects that straddled the medial canthal tendon. The study was approved by the institutional review board at the University of Iowa Hospitals and Clinics. A waiver of informed consent was granted due to the retrospective nature of the study.

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