ePlasty: Vol. 20
Use of a Lateral Orbital Flap for Lateral Canthal Reconstruction: A Case Report
Yuta Nakanishi, MD, Natsuko Kakudo, MD, PhD, and Kenji Kusumoto, MD, PhD

Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan

Correspondence: kakudon@hirakata.kmu.ac.jp
Keywords: lateral orbital flap, lateral canthal reconstruction, the facial nerve, flap necrosis, SMAS (superficial musculoaponeurotic system)


A 72-year-old man visited our hospital with a 10-mm erythema lateral to the left lateral canthus a year prior. Biopsy yielded a diagnosis of squamous cell carcinoma (SCC). The tumor was excised with a 5-mm safety margin, and no tumor was intraoperatively confirmed at the wound margins (Fig 1). To reconstruct the excised defect of 2 × 2 cm in size, a lateral orbital flap was created to match the color and texture. The island flap was designed outward from the defect (Fig 2). A subcutaneous pedicle including the subcutaneous fat tissue and part of the orbicularis oculi muscle was prepared. The island part was elevated (Fig 3) and transferred to the defect, the wound was closed, and the drain was placed at the pedicle site (Fig 4). Good color and texture matching was achieved, and condition of the flap 7 months after the operation is shown in Figure 5.

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