Case of Lower Eyelid Reconstruction with the Reverse Facial Artery Flap for Incomplete Eyelid Closure After Maxillectomy and Radiotherapy

Abstract

Different methods have been used to reconstruct the lower eyelids. Herein, we report a case of lower eyelid reconstruction using a reverse facial artery flap. A 66-year-old woman underwent a partial maxillectomy that included the orbital floor and received radiotherapy for maxillary sinus cancer. The lower eyelid gradually atrophied, resulting in incomplete closure. Thus, lower eyelid reconstruction was performed using a reverse facial artery flap, which was applied for nose and lip reconstruction. However, to date, there have been no reports on lower eyelid reconstruction in Japan. The reverse facial artery flap was a good match for the lower eyelid in terms of color and texture. A relatively large flap was harvested, and the lower eyelid was reconstructed as a unit. The flap was thick, which was favorable for correcting the eyelid depression. Cheek contracture was observed after maxillectomy; therefore, cutting the mimetic muscles to elevate the flap was not considered a newly identified complication. Thus, the application of the reverse facial artery flap may be limited. However, this can be an option for lower eyelid reconstructions.