The Midline Vertical Forehead Flap

The midline vertical forehead flap is an unheralded flap that has valuable and specific application. It is ideal for certain reconstructions around the nose, orbit, and upper melonasal regions. The color match is excellent. The donor area is repaired per primum and because there is a double blood supply, it rarely fails when nondelayed and rotated 180°.

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Interpolated Flaps

Facial Plastic Surgery ◽

10.1055/s-0037-1598170 ◽

2017 ◽

Vol 33 (01) ◽

pp. 034-042 ◽

Cited By ~ 1

Author(s):

Kaveh Karimnejad ◽

Ian Maher ◽

Paul Gruber ◽

Scott Walen ◽

Samkon Gado

Keyword(s):

Blood Supply ◽

Psychological Injury ◽

Nasal Reconstruction ◽

Central Feature ◽

Human Face ◽

Forehead Flap ◽

Future Directions ◽

Donor Tissue ◽

Indian Medical ◽

Iatrogenic Trauma

AbstractNasal reconstruction has been articulated in the literature since 700 B.C. when the earliest iteration of the forehead flap was described in the Indian medical treatise, the Sushruta Samhita. Since then it has evolved into the interpolated flap which has served as a powerful tool for facial reconstruction. The interpolated flap is constructed from nonadjacent donor tissue that has an inherent blood supply. It requires a multistaged approach and is best suited for reconstruction of large or deep defects of the nose. There are three types of interpolated flaps used for nasal reconstruction: the forehead, melolabial, and nasofacial interpolation flaps. The nose is the central feature of the human face and its placement is both aesthetic and functional. Any defects owing to accidental or iatrogenic trauma can cause physiologic and psychological injury to patients. This article aims to review the aforementioned flaps and give indications, contraindications, procedure details, and future directions of these flaps.

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The Extended Lateral Forehead Flap: Today as Was 50-years Ago

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i4.80 ◽

1970 ◽

Vol 1 (4) ◽

Author(s):

Laureen Supit ◽

Gentur Sudjatmiko

Keyword(s):

Stem Cells ◽

Plastic Surgery ◽

Functional Outcomes ◽

Full Thickness ◽

Forehead Flap ◽

Thickness Skin ◽

Donor Area ◽

The Face ◽

Cheek Defect

Background: In the era of surgical advances where institutional pride and status resonates with their progress in the minimal invasives, latest technologies, stem cells, and supermicrosurgeries; some things in plastic surgery never change. The extended lateral forehad flap (ELFF) was first introduced by Ian McGregor in 1963 to reconstruct an intraoral defect, he called it the temporal flap. Gillies and Millard each modified and utilized the flap for patching various facial and intraoral defects and published their experience a year later. Until today in 2012, the ELFF is still largely useful for the reconstruction of wide defects post neoplasms ablation in the face or oral region, which would otherwise require distant flaps or free flaps.Patients and Methods: Three cases of oral and perioral carcinoma were resected and reconstructed using the ELFF to cover for: a full-thickness cheek defect including the lip commisure, an inner oral lining, and a hemipalatal defect.Results: In all, the flaps were tunneled subcutaneously, and donor area grafted by full-thickness skin. All flaps survived and functional outcomes are attained in all patients, with acceptable aesthetic results.Summary: A flap once introduced 49 years ago, is today as consistent and applicable in plastic surgery. This article is an appraisal to the ELFF, and a reminder to the general plastic surgeons, of the simple yet versatile role of ELFF in the reconstruction of facial and intraoral defects.

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Innervation of endoneurial microvessels in human sural nerve

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100125002 ◽

1992 ◽

Vol 50 (1) ◽

pp. 920-921

Author(s):

John L. Beggs ◽

Peter C. Johnson ◽

Astrid G. Olafsen ◽

C. Jane Watkins

Keyword(s):

Blood Flow ◽

Blood Vessels ◽

Blood Supply ◽

Peripheral Nerves ◽

Sural Nerve ◽

Nerve Fibers ◽

Arterial Supply ◽

Autonomic Nerve ◽

Vasa Nervorum ◽

Endoneurial Blood Flow

The blood supply (vasa nervorum) to peripheral nerves is composed of an interconnected dual circulation. The endoneurium of nerve fascicles is maintained by the intrinsic circulation which is composed of microvessels primarily of capillary caliber. Transperineurial arterioles link the intrinsic circulation with the extrinsic arterial supply located in the epineurium. Blood flow in the vasa nervorum is neurogenically influenced (1,2). Although a recent hypothesis proposes that endoneurial blood flow is controlled by the action of autonomic nerve fibers associated with epineurial arterioles (2), our recent studies (3) show that in addition to epineurial arterioles other segments of the vasa nervorum are also innervated. In this study, we examine blood vessels of the endoneurium for possible innervation.

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