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

Abstract

Objective: The current work attempted to assess the median forehead flap (MFF) for reconstruction of mild and moderate defects of the midface after resection of basal cell carcinoma (BCC).Patients and Methods: A total of 20 patients with T1-T2 midface basal cell carcinoma (BCC) were included in this study. Patient’s ages ranged from 60 to 70 years. According to the size of the postsurgical defects> At Tanta Tumor Institute, the patients were categorized into two groups: Group I (GI) included 10 patients with mild defects (2 cm or less) repair using median forehead flap(MFF) and Group II (GII), included 10 patients with moderate defects (more than 2 cm) repair using median forehead flap(MFF).The patients were prospectively evaluated by parameters such as; Flap viability (capillary refill time, bleeding on puncture with a needle and the color of the skin paddle) and esthetic results. Preparation of patients and planning of the surgical technique were necessary to determine the size of the defect were employed for reconstruction of all defects. Results : On comparing the results of GI and GII, the flap viability, patient satisfaction and donor site morbidity were found to be 80%, 70% and 0% in GI compared to 60 %, 60% and 20% in GII respectively (the overall results were: 70%, 65% and 10%respectively). Postoperative infection and partial wound necrosis, were diagnosed in one patient of GI (20%) and was successfully treated with specific antibiotics and local measures; and in 2 (10%) patients of GII that failed to conventional treatment and lost most of the flap (the overall partial and complete flap necrosis was 30%). One patient (5%) of G II showed temporary fistula formation, which disappeared few weeks postoperatively. We conclude that, the median forehead flap insures skin coverage, muscle bulk and good blood supply therefore; it can remain viable additional it is a feasible and reliable technique.