Median Forehead Flap in Reconstruction of the Cutaneous Midface Defects Following Resection of Basal Cell Carcinoma

<p class="Abstract">Reconstruction of soft tissue at the nose following excision of basal cell carcinoma is always challenging, because of both functional and aesthetic importance of nose. The local flap is always preferable to skin graft as this produces “like with like” replacement, pliable cover and vascularized tissue over the skeletal framework. In this paper, we discussed six cases of nasal reconstruction with bilobed flap, forehead flap, and nasolabial flap. All flaps survived and the patients had satisfactory outcome.</p>

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Lateral Forehead Flap in Neglected Giant Basal Cell Carcinoma of the Nose: A Case Report

Indonesian Journal of Cancer ◽

10.33371/ijoc.v13i4.664 ◽

2019 ◽

Vol 13 (4) ◽

pp. 133

Author(s):

Jonathan Kevin ◽

Renate Parlene Marsaulina ◽

Alberta J Jesslyn Gunardi ◽

Irena Sakura Rini

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Donor Site ◽

Nasal Reconstruction ◽

Split Thickness Skin Graft ◽

Reconstruction Method ◽

Forehead Flap ◽

Complex Reconstruction ◽

Nasal Defects

Introduction: Neglected basal cell carcinoma (BCC) of the nose can grow into giant BCCs, rare cases with extensive nasal defects. Such large defects would require complex reconstruction such as free flaps or multiple local flaps. Lateral forehead flap may provide a simpler alternative with good functional and cosmetic results.Case Presentation: We present a case of a 76-year-old man with neglected giant BCC of nose extending to right lower eyelid and upper lip. Wide excision of the tumor leaves a 12cm x 10cm defect. Reconstruction was performed using lateral forehead flap and donor site was covered with split-thickness skin graft from thigh. The second surgery was done after four months to create nostrils and wider eye-opening. Six months later, flap was viable and there was no sign of recurrence. Nasal reconstruction is planned to further improve cosmetics. In this case, neglect is due to low social-economic status and adaptation to painless tumors. The use of lateral forehead flap allows for simpler and faster surgery suitable for elderly. Delayed reconstruction was needed to ensure optimal tissue healing. Conclusions: Neglected BCC causes disfigurement with remarkable morbidity, requiring complex reconstruction. The lateral forehead flap is a simple and reliable reconstruction method for extensive nasal defects with good functional and cosmetic outcomes.

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Nasal reconstruction of extensive defect using axial paramedian forehead flap after staged excision for relapsed basal cell carcinoma

ORL ro ◽

10.26416/orl.41.4.2018.2119 ◽

2018 ◽

Vol 4 (41) ◽

pp. 37

Author(s):

Ioana Dumitrescu ◽

Andrada Stan ◽

Tiberiu Tebeică ◽

Silvius Ioan Negoiță

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Nasal Reconstruction ◽

Forehead Flap ◽

Paramedian Forehead Flap ◽

Extensive Defect

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Keberhasilan jabir bebas forearm dan jabir forehead paramedian pada rekonstruksi defek wajah luas

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v46i1.151 ◽

2016 ◽

Vol 46 (1) ◽

pp. 87

Author(s):

Lina Marlina ◽

Yussy Afriani Dewi ◽

Irra Rubianti ◽

Shinta Fitri Boesoirie

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Radial Forearm Free Flap ◽

Full Thickness ◽

Forehead Flap ◽

Full Thickness Skin Graft ◽

Thickness Skin ◽

Paramedian Forehead Flap ◽

Radial Forearm

Latar belakang: Penutupan defek wajah yang luas dengan jabir bebas forearm dan jabir foreheadparamedian merupakan salah satu pilihan pada pasien pasca eksisi luas dan pemberian radioterapi akibatkeganasan kepala leher. Tetapi cara ini bukan merupakan pilihan yang utama, meskipun memiliki tingkatkeberhasilan yang baik, khususnya pasca radioterapi.Tujuan: Kasus ini diajukan untuk memperlihatkankeberhasilan penutupan defek wajah yang luas dengan jabir bebas forearm, jabir forehead paramedianpasca eksisi luas dan radioterapi pada kasus karsinoma sel basal.Laporan kasus: Dilaporkan seorangperempuan 68 tahun dengan karsinoma sel basal yang dilakukan tindakan eksisi luas dan radioterapi.Penatalaksanaan: Setelah 6 bulan pasca radioterapi, dilakukan penutupan defek dengan menggunakanjabir bebas forearm, dan jabir forehead paramedian yang digunakan sebagai pengganti mukosa hidung sertadilakukan anastomosis radial forearm. Bagian dahi ditutup dengan full thickness skin graft (FTSG) yangdiambil dari regio abdominal pasien.Kesimpulan: Jabir bebas forearm dan jabir forehead paramedianmerupakan salah satu alternatif untuk rekonstruksi defek luas pada daerah kepala leher sesudah radioterapi. Kata kunci: Jabir bebas forearm, jabir forehead paramedian, karsinoma sel basal, radioterapi, eksisi luas ABSTRACTBackground: Paramedian forehead flap and radial forearm free flap is one option for reformationof excessive defect caused by tumor extirpation and radiotherapy in head and neck cancer, but not themain option in head neck reconstruction. In some certain condition, it has a better success rate thanother flap techniques, especially in postradiation patients on facial region. Purpose: To present evidencebased case report in order to show the result of reconstruction in a patient with basal cell carcinomawho underwent wide excision with paramedian forehead flap, radial forearm free flap and radiotherapy.Case report: We reported one case, a 68 years old woman who had basal cell carcinoma and underwentwide excision and radiotherapy. Management: Six months later, we performed reconstructive surgeryto close the forehead defect by reverse paramedian forehead flap, and replacing the nasal mucosa withradial forearm anastomosis, on the forehead covered with a full thickness skin graft (FTSG) taken fromabdominal region of the patient. Conclusion: Radial forearm and paramedian forehead flap can beconsidered as an alternative for reconstruction of wide defect of the head pasca radiotherapy. Keywords: Radial forearm flap, and paramedian forehead flap, basal cell carcinoma, radiotherapy, wideexcision Alamat korespondensi: Lina Marlina, Departemen Ilmu Kesehatan Telinga Hidung Tenggorok-BedahKepala Leher, Fakultas Kedokteran Universitas Padjadjaran/RumahSakit Hasan Sadikin, Bandung,e-mail: [email protected].

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Reconstruction of dorsum of nose after excision of basal cell carcinoma

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201705 ◽

2020 ◽

Vol 6 (5) ◽

pp. 1005

Author(s):

Anshuman Dwivedi ◽

Manmeet Kour ◽

Menka Gupta

Keyword(s):

Elderly Patient ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Malignant Tumors ◽

Forehead Flap ◽

Distal Half ◽

Paramedian Forehead Flap ◽

The Face ◽

Carcinoma Squamous Cell

<p>Basal cell carcinoma, squamous cell carcinoma and melanoma are the most common malignant tumors of the face. The paramedian forehead flap is the standard reconstructive choice for closing large-sized defects of the distal half of the nose. A melolabial interpolation flap and bilobed or trilobed flaps are another option. The dorsal nasal (Rieger) flap is suitable at this location for the closure of small-sized defects, particularly when they are located medially. Here we are discussing an ulcus rodens case we observed in an elderly patient which was treated with a Rieger’s flap.</p>

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Split Lateral Forehead Flap for Reconstruction of Upper and Lower Eyelids

Jurnal Rekonstruksi dan Estetik ◽

10.20473/jre.v4i2.28219 ◽

2021 ◽

Vol 4 (2) ◽

pp. 48

Author(s):

I G. A. N. Widya Pramana ◽

Sitti Rizaliyana

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Tumor Resection ◽

Forehead Flap ◽

Donor Region ◽

Operation Techniques ◽

History Of ◽

The Right ◽

Reconstructive Plastic Surgery

Background: Eyelids reconstruction after tumor resection has be one of the most challenging procedures in reconstructive plastic surgery. Small defects may be closed by primary suture or covered by small local flaps or skin graft. But in large eyelids defects, we need to find a bigger source of color and texture matching tissue that will ensure functional and aesthetical outcomes. Many techniques have been described, but in this case, the author suggest a split lateral forehead flap designed to cover upper and lower eyelids. Patient and Operation Techniques: A Male 51 years-old-patient, presented himself in our clinic with a basal cell carcinoma involving the right upper and lower eyelids. The tumor had a history of 7 years, without any pain or vision disorders involved. Tumor was widely excised, leaving a full thickness on upper and lower eyelids. The inner lining palpebral was replaced by composite auricular graft following by lateral cantophexy. A lateral forehead flap raised with a right temporal pedicle, and the distal part of flap was split in half, and inset into the upper and lower eyelids defect. The donor region was closed with an STSG from Femur Dextra. After 14 days the flap was divided, the functional result was excellent. Discussion: At first, surgeons were worried of raising forehead flaps beyond the midline, fearing that by splitting the distal flap would cause its compropmise. However, rich anastomostic plexus exists between the major forehead angiosomes lined by the smaller calibre “choke” vessels. Conclusions: Periorbital Basal cell carcinoma resection may leave great defect to the underlying tissue. The need to provide adequate support to this structure requires complex techniques with minimum two flaps. In our case, we performed a split lateral forehead flap with a good functional and cosmetic outcome.

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Ultrastructure of Mouse Basal Cell Carcinoma Exhibiting Sebaceous Differentiation

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s1431927600003214 ◽

1980 ◽

Vol 38 ◽

pp. 738-739

Author(s):

Victoria L. Wade ◽

Winslow G. Sheldon ◽

James W. Townsend ◽

William Allaben

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Topical Application ◽

Basal Cell ◽

Sebaceous Gland ◽

Rats And Mice ◽

Mixed Tumors

Sebaceous gland tumors and other tumors exhibiting sebaceous differentiation have been described in humans (1,2,3). Tumors of the sebaceous gland can be induced in rats and mice following topical application of carcinogens (4), but spontaneous mixed tumors of basal cell origin rarely occur in mice.

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