๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
FOREHEAD AND TEMPLE
FOREHEAD AND TEMPLE
The cosmetic boundaries of the frontal and temporal hairlines are well suited for hiding the long arcuate incisions created by rotation flaps. Traditional single-arm rotation flaps and double rotation flaps both have utility in these anatomic locations (Figs. 22-20 and 22-21). Asymmetric double-opposing flaps, one arm of which rotates while the other arm advances, have been shown to be highly effective for reconstructing defects on the temple, mid-forehead, and along the hairline. A recent series demonstrated good cosmesis without any alteration in eyebrow position in defects ranging from 3 to 30 cm.29 Bilaterally symmetric double rotation flaps can also be effective for repair of defects along the hairline. Similar in design to the flap previously described in this chapter for defects on the chin, the long curved incision lines frame the forehead creating two similarly shaped rotation flaps on either side of the defect. These flaps are rotated toward each other and the leading edges are sutured together along the midline after removing a small standing cone deformity inferiorly.
Figure 22 -20. Large defect of the lateral forehead involving the lateral eyebrow. A rotation flap is designed to recruit tissue laxity from the templeโan ample reservoir.
EAR
Though typically not considered a standard reconstructive option on the ear, rotation flaps may be employed to repair few, appropriately selected defects (Fig. 22-22). Specifically, defects of the antitragus may be aptly located for recruiting tissue laxity from the adjacent lobule. A flap with a superomedially based pedicle and an arc of rotation along the curvature of the scaphoid fossa can be rotated to repair defects in this location.
ๅ 22-20
Figure 22-21. Another rotation flap repair of the lateral eyebrow with good cosmetic outcome.
Figure 22-22. Rotation flap repair of the antitragus of the ear. Tissue laxity was recruited from the lobe in this situation.