Use of Giant Bilobed Flap for Advanced Head and Neck Defects

Moustafa Mourad; Demetri Arnaoutakis; Raja Sawhney; David Chan; Yadranko Ducic

doi:10.1055/s-0036-1571808

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2016; 32(03): 320-324
DOI: 10.1055/s-0036-1571808

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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of Giant Bilobed Flap for Advanced Head and Neck Defects

Moustafa Mourad

¹Division of Facial Plastic Surgery, Department of Otolaryngology—Head and Neck Surgery, New York Eye and Ear Infirmary, New York, New York

,

Demetri Arnaoutakis

²Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas

,

Raja Sawhney

³Department of Otolaryngology Head and Neck Surgery, University of Florida, Gainesville, Florida

,

David Chan

⁴Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas

,

Yadranko Ducic

⁴Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas

› Author Affiliations

Abstract

This article aims to review the use of giant bilobed flaps in the reconstruction of various large defects within the head and neck. A single case series study with chart review was performed. Various facial, neck, and mentum defects were documented, and closure was accomplished through a variety of medially and laterally based giant bilobed flaps. Preoperative and postoperative photography, as well as intraoperative planning, was performed. A total of 23 patients were able to achieve closure of facial, head, and neck defects with single-stage closure through the use of a giant bilobed flap. No tissue expanders, free tissue transfers, or skin grafts were required to achieve final closure, with acceptable cosmetic and functional results. Bilobed-shaped flaps allow for local tissue transfer in regions of otherwise limited tissue laxity and mobility, classically designed and utilized in the region of the nose. We describe its applicability to closure of large head and neck defects that may otherwise require free tissue transfer or the use of tissue expanders.

Keywords

Mohs excision - bilobed flap - single-stage closure - facial defects

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References

References
1 Esser J. Gestielte loakle Nasenplastik mit zweizipfligen Lappen, Deckung des sekundaren Defektes vom ersten Zipfel durch den Zweiten. Dtsch Zschr Chir 1918; 143: 385
2 Zitelli JA. The bilobed flap for nasal reconstruction. Arch Dermatol 1989; 125 (7) 957-959
3 McGregor JC, Soutar DS. A critical assessment of the bilobed flap. Br J Plast Surg 1981; 34 (2) 197-205
4 Sutton AE, Quatela VC. Bilobed flap reconstruction of the temporal forehead. Arch Otolaryngol Head Neck Surg 1992; 118 (9) 978-982 , discussion 983–984
5 Baker SR. Local Flaps in Facial Reconstruction. Philadelphia, PA: Elsevier Health Sciences; 2014
6 Chu EA, Byrne PJ. Local flaps I: bilobed, rhombic, and cervicofacial. Facial Plast Surg Clin North Am 2009; 17 (3) 349-360
7 Moy RL, Grossfeld JS, Baum M, Rivlin D, Eremia S. Reconstruction of the nose utilizing a bilobed flap. Int J Dermatol 1994; 33 (9) 657-660
8 Ibrahim AMS, Rabie AN, Borud L, Tobias AM, Lee BT, Lin SJ. Common patterns of reconstruction for Mohs defects in the head and neck. J Craniofac Surg 2014; 25 (1) 87-92
9 Collins SC, Dufresne Jr RG, Jellinek NJ. The bilobed transposition flap for single-staged repair of large surgical defects involving the nasal ala. Dermatol Surg 2008; 34 (10) 1379-1385 , discussion 1385–1386
10 Salgarelli AC, Cangiano A, Sartorelli F, Bellini P, Collini M. The bilobed flap in skin cancer of the face: our experience on 285 cases. J Craniomaxillofac Surg 2010; 38 (6) 460-464
11 Iddings D, Azzizadeh B, Osborne R. Reconstruction of a massive facial cutaneous defect with a bilobed transposition flap. Ear Nose Throat J 2006; 85 (5) 309-310
12 Longo B, Ferri G, Fiorillo A, Rubino C, Santanelli F. Bilobed perforator free flaps for combined hemitongue and floor-of-the-mouth defects. J Plast Reconstr Aesthet Surg 2013; 66 (11) 1464-1469
13 Longo B, Belli E, Pugliese P, Ferri G, Santanelli F. Bilobed skin paddle fibula flap for large oromandibular defects. J Craniofac Surg 2013; 24 (4) e327-e330
14 Cook JL. A review of the bilobed flap's design with particular emphasis on the minimization of alar displacement. Dermatol Surg 2000; 26 (4) 354-362