DOI QR코드

DOI QR Code

Time-trend analysis of 78 orbicularis oculi myocutaneous flaps in periorbital reconstruction: a single-center retrospective study in South Korea

  • Yong Chan Bae (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Yong Woo Lee (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Chi Hyun Lee (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Hoon-Soo Kim (Department of Dermatology, Pusan National University School of Medicine)
  • 투고 : 2025.07.01
  • 심사 : 2025.10.16
  • 발행 : 2025.10.20

초록

Background: The orbicularis oculi myocutaneous (OOMC) flap offers an excellent match in color, thickness, and texture for periorbital defects, yet large-scale, long-term data remain scarce. To determine whether indications, flap-design preferences, and complication profiles change as surgical experience accumulates, cases were stratified into an early practice phase (2001-2017) and a contemporary phase following technique refinement and wider adoption (2018-2024). Methods: All periorbital reconstructions utilizing OOMC flaps between November 2001 and December 2024 were retrospectively reviewed. Cases were stratified into Group A (2001-2017) and Group B (2018-2024). We analyzed patient age, sex, etiology, defect site/number, flap design (V-Y advancement, unipedicle/bipedicle switch, pivot), adjunctive procedures, and complications. Results: Seventy-eight OOMC flaps were performed in 57 patients for 70 defects. Group A included 25 patients, 30 defects, and 36 flaps, while Group B included 32 patients, 40 defects, and 42 flaps. Basal cell carcinoma was the leading etiology in both periods (77%). The proportion of V-Y advancement flaps rose from 50% (18/36) in Group A to 83% (35/42) in Group B. No flap necrosis occurred, and tumor recurrence was observed only once in Group A. Conclusion: Despite the relatively short observation window for Group B, OOMC flap use increased markedly, confirming that accumulated surgical experience promotes even more frequent application in periorbital reconstruction. The V-Y advancement variant, in particular, expanded in indication without added morbidity and appears highly reliable for a broad spectrum of periorbital defects.

키워드

과제정보

This work was supported by a 2-year research grant from Pusan National University.

참고문헌

  1. Yuce S, Demir Z, Selcuk CT, Celebioglu S. Reconstruction of periorbital region defects: a retrospective study. Ann Maxillo‑fac Surg 2014;4:45-50. https://doi.org/10.4103/2231-0746.133077
  2. Park SH, Elfeki B, Eun S. Laterally based orbicularis oculi myo-cutaneous flap: revisiting for the secondary ectropion correc‑tion. J Craniofac Surg 2019;30:e157-60. https://doi.org/10.1097/SCS.0000000000005081
  3. Lopez R, Lauwers F, Paoli JR, Boutault F, Guitard J. The vascular system of the upper eyelid: anatomical study and clinical interest. Surg Radiol Anat 2008;30:265-9. https://doi.org/10.1007/s00276-008-0323-8
  4. Lee MH, Kim HS, Bae YC. Comparison of local flaps versus skin grafts as reconstruction methods for defects in the medial canthal region. Arch Craniofac Surg 2024;25:133-40. https://doi.org/10.7181/acfs.2024.00220
  5. Demir Z, Yuce S, Karamursel S, Celebioglu S. Orbicularis oculi myocutaneous advancement flap for upper eyelid reconstruction. Plast Reconstr Surg 2008;121:443-50. https://doi.org/10.1097/01.prs.0000297649.71049.ae
  6. Okada E, Iwahira Y, Maruyama Y. The V-Y advancement myo‑tarsocutaneous flap for upper eyelid reconstruction. Plast Reconstr Surg 1997;100:996-8. https://doi.org/10.1097/00006534-199709001-00025
  7. Stafanous SN. The switch flap in eyelid reconstruction. Orbit 2007;26:255-62. https://doi.org/10.1080/10717540600987513
  8. Krishnamurthy A, Vaidhyanathan A. 'Switch flap' for full thickness upper eyelid reconstruction. J Cutan Aesthet Surg 2011;4: 148-50. https://doi.org/10.4103/0974-2077.85045
  9. Kim GW, Bae YC, Kim JH, Nam SB, Kim HS. Usefulness of the orbicularis oculi myocutaneous flap in periorbital reconstruction. Arch Craniofac Surg 2018;19:254-9. https://doi.org/10.7181/acfs.2018.02019
  10. Kim JW, Kim SE. Primary cutaneous mucinous carcinoma in a periorbital lesion: two case reports and literature review. Arch Craniofac Surg 2024;25:90-4.
  11. Kim SW, Han HH, Jung SN. Orbicularis oculi myocutaneous island flap for upper eyelid reconstruction. J Craniofac Surg 2012;23:746-8. https://doi.org/10.1097/SCS.0b013e31824dbdb6
  12. Rosa J, Casal D, Moniz P. Upper eyelid reconstruction with a horizontal V-Y myotarsocutaneous advancement flap. J Plast Reconstr Aesthet Surg 2010;63:2013-7. https://doi.org/10.1016/j.bjps.2010.01.026
  13. Tei TM, Larsen J. Use of the subcutaneously based nasolabial flap in lower eyelid reconstruction. Br J Plast Surg 2003;56:4203.
  14. Stagno d'Alcontres F, D'Amico E, Colonna MR, Quatra F, Lupo F. The orbicularis oculi myocutaneus flap in the repair of the medial canthal region. A new strategy for canthal resurfacing. Br J Plast Surg 2004;57:540-2. https://doi.org/10.1016/j.bjps.2004.03.001
  15. Han J, Kwon ST, Kim SW, Jeong EC. Medial and lateral canthal reconstruction with an orbicularis oculi myocutaneous island flap. Arch Plast Surg 2015;42:40-5. https://doi.org/10.5999/aps.2015.42.1.40
  16. Porfiris E, Kalokerinos D, Christopoulos A, Damilakos P, Ioannidis A, Georgiou P. Upper eyelid island orbicularis oculi myo‑cutaneous flap for periorbital reconstruction. Ophthalmic Plast Reconstr Surg 2000;16:42-4. https://doi.org/10.1097/00002341-200001000-00008
  17. Poh EW, O'Donnell BA, McNab AA, Sullivan TJ, Gaskin B, Malhotra R, et al. Outcomes of upper eyelid reconstruction. Ophthalmology 2014;121:612-3. https://doi.org/10.1016/j.ophtha.2013.10.010