Fig 1 - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Rhomboid flap designs. a, classical rhomboid flap by limberg. B, Rhomboid flap for circular defects by Quaba/Sommerland. c, Modified rhomboid flap for medial canthal defects.
Source publication
The reconstruction of medial canthal defects is often challenging in achieving continuity of color and texture, obtaining adequate tissue for large defects, and the reproduction of natural external appearance with inconspicuous scars. We describe a technique for reconstruction of the medial canthal area, using a modified rhomboid flap.
Methods:
T...
Contexts in source publication
Context 1
... mostly above the medial canthal tendon, the rhomboid flap is marked on the skin, starting with a line horizontally on the nose parallel to relaxed skin tension lines (RSTL) in continuity with the defect. The chosen diagonal is extended equal to its own length. The other side of the flap is equal to the extension, drawn at approximately 60 degrees (Fig. 1). For defects located mostly below the medial canthal tendon, the rhomboid flap is marked, starting with a line in continuity with the defect at the junction of the aesthetic units of the nose and cheek equal to the length of the diameter of the defect. The other side of the flap is equal to the extension, drawn at approximately 60 ...
Context 2
... 1). For defects located mostly below the medial canthal tendon, the rhomboid flap is marked, starting with a line in continuity with the defect at the junction of the aesthetic units of the nose and cheek equal to the length of the diameter of the defect. The other side of the flap is equal to the extension, drawn at approximately 60 degrees (Fig. 1). For large defects of the medial canthal region, the defect is imagined to be divided into two round defects. The upper part of the defect is covered with one rhomboid and the lower part with another rhomboid flap, as described. If necessary both flaps can be trimmed to fit perfectly (Figs. 2, ...
Context 3
... the classic design of the Limberg flap allows only four possible choices of flaps, the modifications first described by Quaba allow an unlimited choice of flaps, placing the donor scar at the least conspicuous site 12 ( Fig. 1). So, in the highly noticeable area of medial canthal defects, the rhomboid flap can be planned to obey natural relaxed skin tension lines and the boarders of aesthetic units. Ideally, the scar is largely horizontal across the bridge of the nose and a relaxed skin tension line may be hidden in the natural skin crease at the root of the ...
Context 4
... planned to obey natural relaxed skin tension lines and the boarders of aesthetic units. Ideally, the scar is largely horizontal across the bridge of the nose and a relaxed skin tension line may be hidden in the natural skin crease at the root of the nose 10 or located at the nasofacial junction, resulting in an inconspicuous positioned donor scar (Figs. 1-3). Moreover, compared with frequently used glabellar flaps, the tendency of drawing the eyebrows together can be reduced. However, one disadvantage is the proclivity toward pincushioning in superiorly based rhomboid ...
Context 5
... reconstruction. Unlike the description of Quaba, which uses a smaller flap for the defect by extending the diagonal only by about two-thirds, in our modification the diagonal was extended an equal length to avoid/minimize tension at the defect site to gain enough tissue to restore the medial canthal concavity and prevent tenting of the flap (Fig. 1). By combining a superiorly and inferiorly based rhomboid flap, the technique can also be used to cover large defects with inconspicuous scars. Contrary to antigravity flaps, a rhomboid flap based on the dorsum of the nose has no tendency to ectropion formation because of the opposing vector. The potential for ectropion formation for ...
Similar publications
Herniation of the buccal fat pad in pediatric patients is a rare injury, occurring due to a breach in the buccinator muscle, often termed traumatic pseudolipoma in infants. This condition plays a crucial role in cheek contour in adults. Two case reports detailing the management of this rare injury in young children emphasize the importance of asses...
Objective
Currently, there is no up‐to‐date guideline for the treatment of buccal mucosal squamous cell carcinoma (BMSCC) in the Netherlands. A questionnaire was used to investigate the opinions of Dutch head and neck surgeons on BMSCC of the cheek treatment.
Methods
A questionnaire was sent to all 91 head and neck surgeons in the Netherlands. The...
A 67-year-old female was treated for a left nasal ala basal cell carcinoma; post-Mohs defect was 1.5 × 1.5 cm and extended to involve the perialar cheek and apical triangle of the upper lip. How would you repair this defect?
Introduction: Head and neck skin cancers are the most frequent malignancies in Iran and across the globe. Skin malignancies are caused by a variety of risk factors, including sunshine and vitamin D deficiency. Despite the relatively high number of sunshine days per year in Southern Khorasan, there is insufficient research investigating skin maligna...
![Fig. 1. REALY: a Region-aware benchmark based on the LYHM [18] dataset....](publication/359368203/figure/fig1/AS:1135945332072449@1647841880595/REALY-a-Region-aware-benchmark-based-on-the-LYHM-18-dataset-Our-benchmark-contains_Q320.jpg)
The evaluation of 3D face reconstruction results typically relies on a rigid shape alignment between the estimated 3D model and the ground-truth scan. We observe that aligning two shapes with different reference points can largely affect the evaluation results. This poses difficulties for precisely diagnosing and improving a 3D face reconstruction...
Citations
... 22 Finally, the rhombic flap has been shown to lead to alar retraction and pincushioning if there are miscalculations when trimming the defect. 23,24 The modified supratrochlear artery forehead flap (MSTAFI) has been shown to lead to acceptable aesthetic restoration along with a satisfying color match in patients with nasal defects. 25 The MSTAFI is a modification of a supratrochlear artery forehead island flap, which leads to distorted eyebrows and limited reach, which would potentially require a second stage. ...
Background:. The medial canthus represents the medial confluence of the upper and lower eyelid margins and plays an integral role in the lacrimal duct system. Various flaps have been utilized for the reconstruction of the lower eyelid in the medial canthal region. Our institution primarily utilizes the paramedian forehead flap for the reconstruction of medial canthus defects. Our study looked to evaluate the work of a single plastic surgeon and identify their postoperative outcomes.
Methods:. A retrospective chart review was conducted at Beaumont Health System, Royal Oak, for patients who underwent medial canthal repair by the lead surgeon between the years 2014 and 2018. Demographic data, operative details, complications, medical comorbidities, and patient outcomes were retrospectively gathered and analyzed.
Results:. A total of five patients were isolated. Patients underwent paramedian forehead flap medial canthal repair by the lead surgeon and were found to tolerate the procedure well. All patients had clinically viable flaps with aesthetically pleasing results.
Conclusions:. Utilization of the paramedian forehead flap leads to successful medial canthal repair with adequate coverage. Although the paramedian forehead flap requires three stages to complete, the procedure leaves patients with aesthetically pleasing results. In addition, the paramedian forehead flap has limited cases of ectropion. With the right expertise and patient population, the paramedian forehead flap can be highly successful in the repair of medial canthal defects.
