Orbital Reconstruction with Free Flaps after Orbital Exenteration

ABSTRACT

PURPOSE: To report the results of the orbital reconstruction with microvascular free flap following orbital exenteration in patients with orbital malignancy. METHODS: We performed microvascular free-tissue reconstruction for extensive orbital defects immediately after exenteration in 6 patients. RESULTS: The causes for exenteration were adenocystic carcinoma of the lacrimal gland (2), squamous cell carcinoma of the upper eyelid (1), the nasolacrimal duct (1), maxillary sinus (1), and the ethmoid sinus (1). The extensive orbital defects were reconstructed with the rectus abdominis flaps in 3 patients, with the radial forearm flaps in two, and with the scapular flap in one patient. There was no flap loss. There was no donor site complication. CONCLUSIONS: Microvascular free-tissue transfer allowed successful facial reconstruction in patients with extensive orbital and periorbital defects. It seemed to permit reliable, expeditious, one-stage reconstruction of the orbital defects.