{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:40:21Z","timestamp":1756359621067,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Naso-conjunctival fistula is a rare complication of endoscopic tumour resection. There is a composite deficiency of supporting medial orbital wall and the mucosal linings. A resilient but pliable flap is needed to form the partition, anchor the medial canthus and fill up the orbital volume defect. We present a case of a man in his late 70s having a fistula in the left eye with complaints of air blows during breathing and frequent epiphora for 6 months. He had a lax lower eyelid with clinically evident enophthalmos. The patient was previously operated for locally invasive inverted papilloma. The radiology of the face showed absent medial and inferior orbital walls. The galea\u2013pericranium flap was harvested, tunnelled into the defect and fixed inferiorly to the maxillary periosteum. The fistula got closed and the epiphora improved with no air reflux at subsequent follow-ups. A secondary medial canthal suspension was done at 2\u2009months for a lax lower eyelid.<\/jats:p>","DOI":"10.1136\/bcr-2024-263759","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T02:38:08Z","timestamp":1743734288000},"page":"e263759","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Naso-conjunctival fistula: a rare variant managed with vascularised galea\u2013pericranium flap"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1991-1598","authenticated-orcid":false,"given":"Parampreet Singh","family":"Saini","sequence":"first","affiliation":[{"name":"Burns and Plastic Surgery, AIIMS, Bilaspur, Himachal Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8015-5016","authenticated-orcid":false,"given":"Kajal","family":"Mehta","sequence":"additional","affiliation":[{"name":"Burns and Plastic Surgery, AIIMS, Bilaspur, Himachal Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4740-2506","authenticated-orcid":false,"given":"Navneet","family":"Sharma","sequence":"additional","affiliation":[{"name":"Burns and Plastic Surgery, AIIMS, Bilaspur, Himachal Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7656-4465","authenticated-orcid":false,"given":"Rajesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Indira Gandhi Medical College, Shimla, Himachal Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"2025082722164332000_18.4.e263759.1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000530"},{"key":"2025082722164332000_18.4.e263759.2","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701010"},{"key":"2025082722164332000_18.4.e263759.3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.ophtha.2006.06.038","article-title":"Sino-orbital Fistula","volume":"114","author":"Limawararut","year":"2007","journal-title":"Ophthalmology"},{"key":"2025082722164332000_18.4.e263759.4","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000005082","article-title":"Reconstruction of the Exenterated Orbit with an Island Pericranial Flap: A New Surgical Approach","volume":"11","author":"Kuehnel","year":"2023","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2025082722164332000_18.4.e263759.5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jcjo.2021.02.005","article-title":"Total orbital exenteration with temporalis muscle transfer and secondary healing","volume":"57","author":"Lema\u00eetre","year":"2022","journal-title":"Can J Ophthalmol"},{"key":"2025082722164332000_18.4.e263759.6","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1002\/lio2.471","article-title":"Vascular pedicled flaps for skull base defect reconstruction","volume":"5","author":"Gutierrez","year":"2020","journal-title":"Laryngoscope Investig Oto"},{"key":"2025082722164332000_18.4.e263759.7","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1055\/s-2004-817696","article-title":"The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects","volume":"13","author":"Newman","year":"2003","journal-title":"Skull Base"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:16:53Z","timestamp":1756358213000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":7,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,3]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2024-263759"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263759","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}