A novel surgical procedure for medical canthal fistula closure in midline destructive lesions
Author: Meydan Ben Ishai
Base Hospital / Institution: Sussex Eye Hospital, Brighton, UK
ePoster presentation
Abstract ID: 24-218
Purpose
Medial canthal fistula in the context of destructive processes poses a significant surgical challenge. We report closure of the fistula using a novel Back-to-Back Sandwich Flap (B2BSF) in two patients, one with cocaine-induced midline destructive lesions (CIMDL) and the other with fistula secondary to radiotherapy for SCC and DCR surgery.
Methods
The surgery involves fashioning a paired inner layer inverted local skin flap covered by an outer layer skin glabellar to create a double layer back to back flap.to cover the defect. It was used to close a 2.5 by 2.5 mm fistula in one patient with CIMDL and a 0.5 by 1 mm in a second patient with radiotherapy damage post-SCC.
Results
Three months post-surgery, the fistula remained closed in both patients.
Conclusion
Medial canthal fistula can compromise the ocular surface and vision and is unsightly and uncomfortable. It is difficult to close the fistula, particularly in a destructive process with unhealthy and avascular surrounding tissue. The B2BSF appears to be an effective surgical reconstructive strategy for this challenging situation.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Simerdip | Kaur | Sussex Eye Hospital, Brighton, UK |
| Huw | Oliphant | Sussex Eye Hospital, Brighton, UK |
| Saul | Rajak | Sussex Eye Hospital, Brighton, UK |
