Norwich/Ipswich collaboration leads to UK first

A woman with rare tear duct cancer who ended up with a hole in her face has had a unique operation carried out thanks to a Norwich and Ipswich surgeon working together.

The operation, understood to be the first one of its kind to be successful, involved  a flap of skin from the middle of the nasal lining being created on the inside of Linda Tregidon’s nose and an outer flap of skin from the forehead joining  on the outside.

The result of the operation carried out at the Norfolk and Norwich University Hospital has delighted Linda, from Hadleigh in Suffolk, who at one time feared she would lose her eye.

Linda explained that she went to the opticians with watery eyes and was sent to Ipswich Hospital to have her tear ducts flushed. But a biopsy showed she had cancer of the tear duct with two tumours.
The tumours were removed by Norwich surgeon Bijan Beigi at the NNUH in early December. That was followed by 30 sessions of radiotherapy over six weeks at Ipswich Hospital. Unfortunately Linda suffered a recognised side-effect and the hole – about the size of a £2 coin- appeared at the side of her nose.

So, Mr Bijan Beigi and his Ipswich colleague Mr Matthew Yung, an ENT surgeon, who had both run  courses together for 15 years, decided to collaborate, unusually using both flaps.
Mr Beigi, a complex oculo plastic and reconstructive surgeon explained “We have called it the Norwich flap and the Ipswich flap. They have not been used together in this way before. Sandwiching them together means the inside one supports the outside flap of skin and then it will grow its own circulation and the graft can survive.”

He said he was really pleased with the way the two and a half hour operation had gone, and took out the stitches just before Christmas.
On the day she had her stitches removed a delighted Linda said she was positive during her treatment that she knew she had the best “Mr Beigi and Mr Yung have been amazing”.  She added that the skin that had been grafted would be smoothed out later

Linda said during the whole of her treatment she only needed nine days off work. Full of praise for her treatment she said “There have been very little downsides; it has been a very positive experience.”
Linda has also had the good news that there is no evidence of a recurrence of the disease and so she and her husband, Dave, are busy planning a big holiday.

Mr Beigi explained that the collaboration between the two surgeons was unusual but he and Mr Yung had run a course for lacrimal surgeons for the past 15 years.
He explained that the first flap was constructed by Mr Yung from the middle wall nasal lining and then attached to the holes in the bone on the side of Linda’s face. The Norwich surgeon then took a flap of skin from Linda’s forehead that was attached to the base of the skull and then joined it to the other one “like a sandwich”. He said the nasal flap had rarely been used to cover a hole.
He said he was very pleased with the result and could not find any other occasion the two flaps have worked like this. They now plan to write it up for their medical journals.