PMC4914532_01
Preoperative view, a 76-year-old woman with widespread basal cell carcinoma involving the whole right and central midface
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Fig1
A 76-year-old woman presented to our department, requiring facial reconstruction following radical resection of a widespread basal cell carcinoma, involving the right orbit, the anterior base of the skull with infiltration of the dura mater, the cheek, the whole nose, upper lip, right maxilla, the pterygopalatine fossa, and the right epipharynx (Figs. 1 and 2).
Intraoperative photo during radical resection. A 76-year-old woman with widespread basal cell carcinoma involving the whole right and central midface
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Fig2
A 76-year-old woman presented to our department, requiring facial reconstruction following radical resection of a widespread basal cell carcinoma, involving the right orbit, the anterior base of the skull with infiltration of the dura mater, the cheek, the whole nose, upper lip, right maxilla, the pterygopalatine fossa, and the right epipharynx (Figs. 1 and 2).
The DCIA perforator flap variant shown intraoperatively, with its long vascular pedicle connecting the osteomyocutanous part and the skin paddle
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Fig3
Due to the superolateral location of the skin paddle, it was possible to mobilize a 15 cm vascular pedicle together with the bone and muscle, located proximally (Figs. 3 and 6).
The patient immediately postoperatively
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Fig4
The huge epidermal defect, also involving the right orbit due to loss of the eye, was covered with the highly mobile skin paddle (Fig. 4).
The patient several weeks after surgery, wearing her epithesis of the nose and right eye
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Fig5
The patient also received an epithesis including the nasal and right orbital area and had an excellent functional and aesthetic result (Figs. 5, 7 and 8).
Schematic illustration of the intraoperative anatomical situation of the groin region in this unique case
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Fig6
Due to the superolateral location of the skin paddle, it was possible to mobilize a 15 cm vascular pedicle together with the bone and muscle, located proximally (Figs. 3 and 6).
Preoperative computer tomography scan showing complete destruction of the right maxilla and hard palate and bony infiltration of the orbital floor, zygomatic bone and ethmoidal cells
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Fig7
The patient also received an epithesis including the nasal and right orbital area and had an excellent functional and aesthetic result (Figs. 5, 7 and 8).
Postoperative computer tomography scan showing the bony reconstruction of the zygomatic contour and the maxilla and partial reconstruction of the bony orbit
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Fig8
The patient also received an epithesis including the nasal and right orbital area and had an excellent functional and aesthetic result (Figs. 5, 7 and 8).