Expanded forehead flaps for reconstruction of different faciocervical units: selection of flap types based on 143 cases.

BACKGROUND

Forehead flaps have been used in the reconstruction of one particular faciocervical region, such as the nose and periorbital unit. The aims of the present study were to determine whether all the unit/multiunits of the face and neck could be aesthetically reconstructed by using expanded forehead flaps and to propose a strategy for flap selection for the reconstruction of different faciocervical units.

METHODS

The authors systematically reviewed the application of expanded forehead flaps for cervicofacial rehabilitation in their center from 2000 to 2013.

RESULTS

Four types of expanded forehead flaps were used for the faciocervical reconstruction of 143 patients. Type I was a pre-expanded local flap used for repairing defects of the partial forehead unit, subunits of the periorbital unit, or partial involvement of the two adjacent units. Type II was an expanded paramedian forehead flap used for resurfacing the nose, orbital unit, upper cheek unit, and partial involvement of these adjacent units. Type III was a bilateral pedicled expanded forehead flap for the reconstruction of the lower face and anterior neck. Type IV was a unilateral pedicled expanded forehead flap, based on the superficial temporal vessels, used to reconstruct the ipsilateral part of the middle face.

CONCLUSIONS

The four types of expanded forehead flap can be used for the reconstruction of different faciocervical units. Based on the location and size of the defect or lesion, the selection of these flaps can be planned preoperatively.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.