A Rare Case of Hyena Bite - Reconstruction of Complex Central Face Defect with Folding Free Radial Forearm Flap: A Case Report

Abstract

Background: A hyena bite to the face of a live adult human is one of the rarest cases and is hardly reported in India. The central face is an intricate 3-Dimensional structure and is a dominant feature of a human being. A complex central facial defect can severely affect a person’s appearance and function; and poses a substantial challenge for reconstructive surgeons. The aim and principles of central facial reconstruction are to achieve adequate function and aesthetics. Case Report: This report describes a very rare case of a 43-year-old man, resident of a rural part of Rajasthan state of India, who sustained a massive injury in the central face after getting bitten by a hyena. A free radial forearm flap was designed as a multiple folding, double paddle flap that was divided into several portions. The folded portions of the flap were used to reconstruct the nose, oral mucosa and the upper lip defects and while a downturned forehead flap provided the lining for nasal mucosa reconstruction. The patient achieved a good functional recovery and had a good aesthetic outcome. Conclusion: One of the rarest cases reported in the literature, where timely intervention was done is nothing short of a miracle. Meticulous preoperative planning and harvesting of flaps enabled the achievement of good aesthetic and functional results in the present patient.