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September 1996

Doppler-Assisted Vascular Pedicle Flaps in Eyelid and Periorbital Reconstruction

Author Affiliations

From the Departments of Ophthalmology (Drs Yeatts and Newsom) and Otolaryngology (Drs Yeatts and Matthews), The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC. The authors have no proprietary interest in either the method presented or in Parks Medical Electronics Inc, nor have they received payment as a consultant or evaluator of the products.

Arch Ophthalmol. 1996;114(9):1149-1152. doi:10.1001/archopht.1996.01100140351024

The use of a transcutaneous ultrasonic Doppler flow detector to identify the supratrochlear and superficial temporal arteries permits the design of narrow-based, thin-tipped forehead flaps for use in medial canthal and eyelid reconstruction. In the 13 cases described, the axial, vascular supply of a proposed myocutaneous forehead flap was determined with a transcutaneous ultrasonic Doppler flow detector permitting narrow-based pedicle widths of 0.8 to 1.2 cm. The design of the distal portion of the flap was determined by the primary defect. The width of the flap varied from 1.5 to 4.0 cm, with the flap's axial length limited only by the hairline. This use of the ultrasonic Doppler flow detector, permitting narrow-based, thintipped vascular pedicle flaps, has assisted in refining the concept of forehead flaps and has made these flaps an acceptable primary reconstructive technique in the periorbital region.

Shumrick KA, Smith TL.  The anatomic basis for the design of forehead flaps in nasal reconstruction . Arch Otolaryngol Head Neck Surg 1992;118:373-379.Article
Dortzbach RK, Hawes MJ.  Midline forehead flap in reconstructive procedures of the eyelids and exenterated socket . Ophthalmol Surg . 1981;12:257-268.
McCord CD, Wesley R.  Reconstruction of the upper eyelid and medial canthus . In: McCord CD Jr, Tanenbaum M, eds. Oculoplastic Surgery . 2nd ed. New York, NY: Raven Press; 1987:73-91.
Carraway JH.  Reconstruction of the eyelids and eyebrows and correction of ptosis of the eyelid . In: Smith JW, Sherrell JA, eds. Grabb and Smith's Plastic Surgery . Boston, Mass: Little, Brown & Co; 1979:425-463.
Conley J.  Pendulosity in regional flaps about the head and neck . Ann Plast Surg . 1986;16:75-83.Article
Marchac D, Toth B.  The axial frontonasal flap revisited . Plast Reconstr Surg . 1985;76:686-694.Article