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September 1992

Bilobed Flap Reconstruction of the Temporal Forehead

Author Affiliations

Seattle, Wash

Arch Otolaryngol Head Neck Surg. 1992;118(9):983-984. doi:10.1001/archotol.1992.01880090099025

Drs Sutton and Quatela have presented us with an excellent review of one option for reconstruction of large surgical defects of the temple. To place their contribution in perspective, some specific anatomic considerations and alternative reconstructive options will be discussed. Finally, a conceptual approach to the design of transposition flaps will be described.

See also p 978.

The temple represents a unique aesthetic unit of the face. It is concave and has thinner skin than the adjoining cheek, scalp, and forehead; as the authors note, the temple skin itself becomes thicker posteriorly as it adjoins the scalp. Superiorly, it meets the relatively immobile forehead skin at approximately the junction of the frontalis muscle. Anteriorly, it extends to the orbital rim and the orbital aesthetic unit. Although the skin over the lateral orbit is reasonably mobile, it cannot be significantly advanced into the temple without distorting the lateral canthus. Posteriorly, the

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