Use of a flap of extraocular muscle and fat during subtotal exenteration to repair bony orbital defects

PURPOSE: To describe a technique for the primary repair of bony defects between the orbit and adjacent structures during subtotal exenteration. DESIGN: Interventional case reports. METHODS: A flap composed of orbital fat supported by an extraocular muscle pedicle was used to fill a defect between the orbit and the nasal cavity in one case, and to buttress a fascia lata graft covering exposed dura mater in one case. RESULTS: The exenterated socket healed satisfactorily without fistula formation in both cases. CONCLUSIONS: Primary repair of communications between the orbit and its surrounding cavities may prevent the development of postoperative fistulae or cerebrospinal fluid leakage.