Osteocutaneous Radial Forearm Flap Reconstruction for Naso-ethmoid-orbital Defects

Abstract

Objectives:

(1) Describe the usefulness of osteocutaneous forearm flaps in reconstruction of the naso-ethmoid-orbital (NOE) defect. (2) Describe a case series outlining the authors’ experiences with this reconstruction.

Methods:

A retrospective review and case series was conducted on patients between 2000 and 2014 who underwent NOE involving resections with reconstruction using radial forearm flap. All disease causes were included and all consecutive patients at 2 institutions were analyzed. Aesthetic results, nasal airway, diplopia, and enophthalmus were assessed in recent patients available. Technical feasibility and methods of reconstruction were assessed, including where bone was plated and which portions of the NOE structure were reconstructed. Patient disease outcomes were included to assess the durability of reconstruction for remaining survival period.

Results:

Fifteen patients underwent NOE reconstruction in the timeframe studied. Four recent patients reported poor nasal airway, but no diplopia, and no immediate enopthalmus after NOE reconstruction. Patients felt their appearance had been positively impacted by reconstruction. One-third of patients succumbed to disease in the study period within 3 years of reconstruction, but without need for additional reconstructions.

Conclusions:

Ostteocutaneous radial forearm flap (OCRFF) is a cosmetically acceptable and functional method of reconstructing a variety of NOE defects. In NOE cancer patients with limited survival, a one-step reconstruction can be serviceable and not require multiple additional procedures, while ensuring aesthetic results and prevention of ocular comorbidity.