Abstract
Background: Medial canthal reconstruction is a challenging task due to its complex anatomy. The glabellar flap is a common viable technique; however, this results in narrowing of the eyebrows, bulky nasal dorsum horizontal scarring, which is aesthetically displeasing, and possible injury of the supratrochlear artery. Multiple variations have been proposed in the literature, which is often complex. In this paper, the senior author (AK) has developed an intuitive, simple technique by utilising half of the glabellar skin in 12 patients with good clinical outcomes.Materials and methods: A rotational advancement flap involving the upper lateral nasal wall with the hemi glabellar was formed and transferred to the medial canthal defect. The donor site was closed in a V-Y manner. Complete closure of defect was achieved in all patients.Results: Reconstruction using the hemi glabellar technique was performed on 12 patients following resection of basal cell carcinoma (BCC) in or near the medial canthus area. Superficial cellulitis was noted in two patients; they were managed on oral antibiotics. Bruising was reported in seven patients which resolved spontaneously in 4-7 days. All patients had a good outcome at two months and six months follow up; there was no flap loss, and all patients were satisfied with the aesthetic outcome.Conclusion: The technique highlighted in this article can be performed quickly and applies to the reconstruction of medial canthus defects with excellent aesthetic outcomes, an inconspicuous scar and supple skin with matching colour.
Highlights
Reconstruction of a medial canthus defect is challenging due to the complex anatomical structure of the lateral nasal wall and the upper and lower eyelid junction [1]
Reconstruction using the hemi glabellar technique was performed on 12 patients following resection of basal cell carcinoma (BCC) in or near the medial canthus area
One of the favored techniques is the glabellar flap because the color, texture, and thickness match with inconspicuous scars
Summary
Reconstruction of a medial canthus defect is challenging due to the complex anatomical structure of the lateral nasal wall and the upper and lower eyelid junction [1]. It is important to avoid distortion of the canthus concavity and maintain eyebrow contour and symmetry during reconstruction. Several methods have been described, including healing by secondary intention, full or partial thickness skin grafts, and local flaps [2-7]. One of the favored techniques is the glabellar flap because the color, texture, and thickness match with inconspicuous scars. Medial canthal reconstruction is a challenging task due to its complex anatomy. The glabellar flap is a common viable technique; this results in narrowing of the eyebrows, bulky nasal dorsum horizontal scarring, which is aesthetically displeasing, and possible injury of the supratrochlear artery. The senior author (AK) has developed an intuitive, simple technique by utilising half of the glabellar skin in 12 patients with good clinical outcomes
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