European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 2, pp 535–540 | Cite as

An original procedure for orbitonasal cutaneous infiltrative tumor repair, using combined forehead and melolabial propeller flaps

  • Clair VandersteenEmail author
  • Dorian Culié
  • Olivier Dassonville
  • Alexandre Bozec
  • Nicolas Guevara
  • Charles Savoldelli
  • Gilles Poissonnet
Head & Neck



Resections of cutaneous tumors in the medial orbitonasal region can be transfixing. Repairs using a single local flap run the risk of failure and that of secondary sinonasal fistula, especially in cases of surgery on a radiated field. We propose an original and reliable repair procedure using two pedicled regional flaps vascularized by two distinct arterial systems clinched together to reconstruct the mucosal and cutaneous planes.

Materials and methods

A first melolabial propeller flap (MPF) with a superior perforating pedicle was elevated and the cutaneous side was sutured to the deep plane of the loss of substance (mucosal lining). A second homolateral or contralateral paramedian forehead flap (PFF) was then lifted and sutured over the first flap (superficial plane). The forehead pedicle flap was divided at 1 month.


No trophic complication or failure was recorded on two patients. The 7-year carcinologic, aesthetic, and functional results were satisfying.


This technique involving the superimposition of two local flaps, vascularized by two different arterial systems, appears to offer a simple and reliable repair technique for transfixing cutaneous losses of substance in the medial orbitonasal region. It could be used in the first-line treatment, particularly if an additional radiotherapy is to be performed.


Nasocutaneous fistula Medial canthus Paramedian forehead flap Melolabial propeller flap 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institut Universitaire de la Face et du CouCentre Hospitalier Universitaire de NICENiceFrance
  2. 2.Institut Universitaire de la Face et du CouCentre Antoine LacassagneNiceFrance

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