-Case Reports-

Bilobed Flap for Reconstruction of Skin Defects after Excision of Parotid Carcinoma: A Case Report

Koji Sakamoto^1,2, Hiroyuki Ozawa³, Masayuki Shimoda⁴, Masashi Nakaishi², Atsuko Sakanushi², Takeshi Matsunobu², Kimihiro Okubo², Takashi Okada¹, Yoichiro Sato¹, Seiichi Shinden¹ and Kaoru Ogawa³

¹Department of Otorhinolaryngology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
²Department of Otorhinolaryngology, Head and Neck Surgery, Nippon Medical School, Tokyo, Japan
³Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, Tokyo, Japan
⁴Department of Pathology, Keio University, Tokyo, Japan

Objectives: Local flaps, pedicled flaps, and free flaps are used to reconstruct medium-sized skin defects after excision of parotid carcinoma. The bilobed flap is a local flap primarily used by plastic surgeons for small defects of nasal skin. We report a case of parotid carcinoma with skin infiltration successfully treated by skin reconstruction with a bilobed flap.
Methods: An 84-year-old man presented with a parotid mass he had noticed 2 months earlier. Parotid carcinoma with skin infiltration was diagnosed and he underwent radical surgery. The skin defect was round (diameter, 6 cm) and was resected and reconstructed with a bilobed flap designed to be caudal to the defect.
Results: Postoperative facial nerve palsy improved within 6 months. The postoperative course was otherwise uneventful, and the patient was discharged on postoperative day 7. Pathological examination revealed a sarcomatoid salivary duct carcinoma.
Conclusions: Bilobed flaps are useful for reconstructing skin defects with a diameter of 6 cm or less.

J Nippon Med Sch 2022; 89: 606-611

Keywords
bilobed flap, parotid gland malignancy, local flap, sarcomatoid salivary duct carcinoma, geriatrics

Correspondence to
Koji Sakamoto, Department of Otorhinolaryngology, Head and Neck Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
k-sakamoto@nms.ac.jp

Received, May 3, 2021
Accepted, August 4, 2021