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Cheek rotation flap reconstruction—an anthropometric appraisal of surgical outcomes

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Abstract

Objectives

Cheek rotation flaps are an established surgical procedure for coverage of facial skin defects especially of the cheek and infraorbital region. A comparison of pre- and postoperative anthropometric measurements may help to objectify intraoperative estimations with regards to postoperative appearance.

Materials and methods

We present an evaluation of 31 patients undergoing periorbital reconstruction by a cheek rotation flap on standardized photographs based on reference anthropometric data. Analysis included intercanthal, binocular and eye fissure width, eye fissure, lid sulcus and upper lid height, upper and lower iris coverage, position of cornea to palpebra inferior, scleral show, ectropion, and canthal tilt. Furthermore, it was clearly differentiated whether the defect to cover included eyelid skin or not.

Results

Ectropion showed a significant association to surgery (p = 0.03) and time (p = 0.03). If the defect to cover included lower eyelid skin, lower iris coverage values decreased significantly (p = 0.02), meanwhile the rate of scleral show increased significantly (p < 0.01), indicating pre- to postoperative lower eyelid retraction.

Conclusions

In all patients analyzed, indices were reproducible and reliable. An association between surgery and ectropion was detectable. Whenever lower eyelid skin is involved in the defect to be covered, the significantly decreased lower iris coverage and increased rate of scleral show indicate an increased risk of lower lid retraction.

Clinical relevance

Whenever eyelid skin is involved in a defect to be covered by a cheek rotation flap, there is an increased risk of postoperative lower lid distortion. Special care has to be taken to perform techniques preventing lower lid retraction.

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Conflict of interest

The authors declare that they have no conflict of interest. There were no sources of funding.

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Authors and Affiliations

  1. Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Gregor F. Raschke, Rolf-Dieter Bader, Stefan Elstner & Stefan Schultze-Mosgau

  2. Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, Markus Krankenhaus, Academic Teaching Hospital, Johann Wolfgang von Goethe University, Wilhelm-Epstein-Straße 4, Frankfurt am Main, Germany

    Ulrich M. Rieger

  3. Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Gregor F. Raschke, Ulrich M. Rieger, Arndt Guentsch & Oliver Schaefer

Authors
  1. Gregor F. Raschke
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  2. Ulrich M. Rieger
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  3. Rolf-Dieter Bader
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  4. Arndt Guentsch
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  5. Oliver Schaefer
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  6. Stefan Elstner
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  7. Stefan Schultze-Mosgau
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Corresponding author

Correspondence to Gregor F. Raschke.

Additional information

Gregor F. Raschke and Ulrich M. Rieger contributed equally to the manuscript

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Raschke, G.F., Rieger, U.M., Bader, RD. et al. Cheek rotation flap reconstruction—an anthropometric appraisal of surgical outcomes. Clin Oral Invest 18, 1251–1257 (2014). https://doi.org/10.1007/s00784-013-1075-3

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  • DOI: https://doi.org/10.1007/s00784-013-1075-3

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