Primary Reconstruction of Extensive Forehead Defects Using Supraorbital Artery Propeller Perforator Flap

Abstract

Extensive resection of skin carcinomas in the periorbital and forehead regions often results in complicated defects involving the upper eyelid, superciliary arch, and nasal dorsum. The aim of this study is to report our experience with the use of supraorbital artery perforator propeller flaps for primary repair of complicated forehead defects. A total of 6 patients underwent carcinoma resection with primary surgical reconstruction using supraorbital propeller flap at the Peking University School and Hospital of Stomatology from December 2015 to December 2018. We describe the technique and retrospectively review the outcomes. A single propeller flap was used in 5 patients and 2 propeller flaps (supraorbital and nasolabial artery propeller flaps) in 1 patient. Two patients developed venous congestion of the flap on the first postoperative day; however, in both cases it was relieved by multiple needle punctures. All flaps had survived well at 1-year follow-up. Five patients had a normal eyelid closure, but 1 patient presented with lagophthalmos, which required correction by secondary surgery. Propeller flap based on the supraorbital artery is a feasible option for primary reconstruction of supraorbital-forehead defect.