ORIGINAL ARTICLE   

European Journal of Oral and Maxillofacial Surgery 2018 August;2(2):25-9

DOI: 10.23736/S2532-3466.18.00133-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Forehead flap setting in facial aesthetic units reconstruction

Massimiliano MANFREDI ✉, Manlio GESSARILO, Massimo BASSI, Angelo CAMPOBASSI

Unit of Maxillofacial Surgery, Department of Neuroscience and Head and Neck, M. Bufalini Hospital, Cesena, Forlì Cesena, Italy

BACKGROUND: The reconstruction of the aesthetic units of the face has always been a complex challenge for plastic and maxillofacial surgeons. Several reconstructive techniques, by now codified, can be used. From swivel flaps to transposition flaps to microvascular free flaps for more complex defects.
METHODS: At the Maxillofacial Surgery operational unit of the Bufalini hospital, we perform about 50 surgical reconstruction operations per year, of the various anatomical districts of the face and neck, 80% of which are the result of the removal of malignant tumors, while the remaining 20% are to be put down to losses of substance following facial trauma. The surgical defects faced vary in size from a few centimeters to complex defects, and each time, the reconstructive techniques are applied which are suitable to the case using flaps which have for some time been codified in literature. As is well known, the paramedian forehead flap remains the gold standard in nasal reconstruction, due to its position, anatomy, and the possibility of performing several surgical operations until the ideal result is achieved. Between 2007 and 2016, 73 reconstructive operations were performed in our O.U., all of which involved the use of the paramedian forehead flap.
RESULTS: None of the patients presented inflammatory complications. One patient presenting squamous cell carcinoma of tip and columella got complicated, presenting unsatisfying esthetic result. One patient prersenting squamous cell carcinoma of tip and alar lobule resulted in low grade dynamic breathing stenosis; one patient presenting squamous cell carcinoma of tiplanol low dorsum complicated in partial necrosis of the forehead flap.
CONCLUSIONS: The paramedian forehead flap is a viable reconstructive option also for regions of the face different from the nose.

KEY WORDS: Forehead - Surgical flap - Skin neoplasms - Nose - Reconstructive surgical procedures