Vascularized nasoseptal flap for medial orbital wall reconstruction

With the use and efficacy of the vascularized nasoseptal flap, its indications are also expanding. Due to its relative ease of harvesting and no significant impairment in the long-term sinonasal quality of life, the flap has been used for a number of other purposes apart from its originally proposed use in reconstruction of the anterior cranial fossa, sella, and the clivus. Its use may negate the need of another incision to obtain fat or fascia. The authors describe the case of a 47-year-old lady who underwent endoscopic excision of a medially placed orbital intraconal hemangioma who presented to us with very poor vision in the left eye. The large medial orbital defect was reconstructed with a vascularized pedicled nasoseptal flap from the ipsilateral side. The patient made an excellent visual and sino-nasal recovery. This patient highlights a unique use for the proliferating indications for the use of the nasoseptal flap.