gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

Indications and limitations of the reconstruction of midface deffects with the forehead flap

Meeting Abstract

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  • corresponding author Thomas Grundmann - ENT DPT, University Hamburg, Hamburg
  • Ullrich Schaudig - Ophalmology University Hamburg, Hamburg

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno075

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2005

© 2005 Grundmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The forehead flap (FHF - Indian flap), used as an fasciocutaneous transposition flap, represents a common technique for the reconstruction of defects of the nose. The pros of this technique are save perfusion in relatively distant regions the cons are higher operative expenditure like two step operation and scarification in the forehead region. We wanted to examine the Indications and limitations using the FHF in facial reconstruction.

Patients and Methods: 98 Patients with larger defects of the midface region, in most cases caused after tumor resection, which were reconstructed with numerous techniques were examined for invasivity of the operative procedure, esthetic and functional outcome of the underlying technique.

Results: Between 1999 and 2004 98 patients with larger defects of the midface region underwent surgical reconstruction – 43 FHF, 31 full skin grafts and 24 other transposition flaps (Esser, Nasolabial, Nelaton). Using the FHF larger defects of the nose, paranasal region, the lid- and the forehead-region can be reconstructed successfully. Variation of the FHF as a two-pedicle flap couvering different regions of the central midface can be reconstructed with the same technique. Combination with other skin flaps (eg Nasolabial sliding flap) could increase the flap range, accompanied deep defects (eg carcinoma of the lacrimal drainage system or the paranasal sinuses) with orbital and skin infiltration combination of the FHF with a fascial transposition flap (suprabrow flap) a multilayer reconstruction is possible. Complications of the FHF as the higher invasiviness (two steps), scareficatin of the forehead or pronounced edema have to be compared with the choice of a stable reconstruction espcially in case of problem wounds.

Conclusion: With the forehead flap a save reconstruction of large defects in the mid- and upper face region can be obtained with the possibility of a combination with other structural and functional reconstruction methods.