{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:32:09Z","timestamp":1747150329961,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe a novel technique for reconstruction of complex defects involving supraorbital rim and orbital roof.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review and description of surgical technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four patients underwent tumor resection with neurosurgery (2 intraosseous hemangioma, 1 meningioma, and 1 ossifying fibroma), with mean tumor size of 42.6 cubic centimeters on preoperative imaging. All defects involved supraorbital rim and orbital roof. Patients were reconstructed with autogenous osseous rib graft for structure and contour and anterolateral thigh fascia lata (ALTFL) free flap to provide robust vascularity to rib bone and as a barrier between skull base dura and the orbit and\/or sinonasal cavities. Two patients underwent resection and reconstruction using minimal access incisions, and two underwent major cranial and skull base resections. All flaps are vascularized via superficial temporal vessels. On postoperative follow\u2010up (mean 33.5\u2009months, range 8\u201348), all patients report no vision change or diplopia, with excellent contour symmetry to contralateral orbit. Follow\u2010up imaging (mean 29.5\u2009months, range 3\u201348) demonstrated maintained orbital volume and retention of rib bone graft compared to immediate postoperative imaging. There were no complications related to graft use. Minor complications include 1 patient with cerebrospinal fluid leak managed with lumbar drain placement and 1 patient with mild enophthalmos at 7\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We describe a series of patients who underwent a novel technique for reconstruction of complex defects involving supraorbital rim and orbital roof with autogenous osseous rib and vascularized ALTFL\u2010free flap with excellent functional and cosmetic outcomes. This can be accomplished using minimal access techniques to minimize patient morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:654\u2013658, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30819","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T11:25:57Z","timestamp":1686828357000},"page":"654-658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Supraorbital Rim and Roof Reconstruction with Vascularized Fascia Lata and Autogenous Rib Graft"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-1502","authenticated-orcid":false,"given":"Sara W.","family":"Liu","sequence":"first","affiliation":[{"name":"Cleveland Clinic, Head and Neck Institute Section of Facial Plastic and Microvascular Surgery  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Frost","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Head and Neck Institute Section of Facial Plastic and Microvascular Surgery  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Fritz","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Head and Neck Institute Section of Facial Plastic and Microvascular Surgery  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0901-5027(00)80045-4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1096199"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1286113"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31825d0b91"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0b013e31815a1235"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS-07\/11\/0905"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.7181\/acfs.2018.01921"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2009.07.005"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2016.05.004"},{"issue":"5","key":"e_1_2_6_11_1","first-page":"795","article-title":"Nonvascularized iliac bone grafts for mandibular reconstruction\u2013requirements and limitations","volume":"25","author":"Handschel J","year":"2011","journal-title":"In Vivo (Brooklyn)"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29709"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103226"},{"issue":"3","key":"e_1_2_6_14_1","article-title":"Fascia lata free flap reconstruction of limited hard palate defects","volume":"10","author":"Kerr R","year":"2018","journal-title":"Cureus"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.447"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:09:04Z","timestamp":1705903744000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,15]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/lary.30819"],"URL":"https:\/\/doi.org\/10.1002\/lary.30819","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2023,6,15]]},"assertion":[{"value":"2023-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}