Complete orbit and forehead reconstruction using a free latissimus dorsi flap and MEDPOR implants

Dimitrios Antonopoulos, Dimitra Tsiliboti, Dimitrios Skarpetas, Aris Masmanidis
Head & Neck 2006, 28 (6): 559-63

BACKGROUND: Reconstruction of enormous composite defects of the face in the presence of meningitis is a difficult problem. We present a case of a 29-year-old man with a huge, posttraumatic bone and soft tissue defect of the upper half of the left side of the face (orbit-zygoma-frontal-partial temporal bones), frontal lobe of the brain, and enucleated eye with intact facial skin.

METHODS: An initial reconstruction using cement was complicated by multiple episodes of meningitis. In a multiple-stage procedure, we used a free latissimus dorsi muscle flap to re-construct the soft tissue defect and control the infection, a complete left orbit and frontal MEDPOR implant for the bone defect, and also an orbital sphere MEDPOR implant for the eyeball.

RESULTS: In a 2-year follow-up, no infection was observed, and the cosmetic result is satisfactory.

CONCLUSION: The combination of free flap and MEDPOR implants demonstrates an alternative method for reconstruction of complicated facial defects.

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