Use of a flap of extraocular muscle and fat during subtotal exenteration to repair bony orbital defects.

Abstract

To describe a technique for the primary repair of bony defects between the orbit and adjacent structures during subtotal exenteration. Interventional case reports. A flap composed of orbital fat supported by an extraocular muscle pedicle was used to fill a defect between the orbit and the nasal cavity in one case, and to buttress a fascia lata graft covering exposed dura mater in one case. The exenterated socket healed satisfactorily without fistula formation in both cases. Primary repair of communications between the orbit and its surrounding cavities may prevent the development of postoperative fistulae or cerebrospinal fluid leakage.