Scuderi N, Rubino C, Bertozzi E
University of Rome La Sapienza, Department of Plastic Surgery, Italy.
Ophthalmic Surg Lasers. 1999 Feb;30(2):91-7.
Full thickness reconstruction of more than half of an eyelid, mainly of the upper one, is a challenge for the surgeon. In 1992, for the first time, the authors reported the use of an axial chondro-mucosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 18 patients operated on using the above technique during the period June 1991-March 1997.
Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, length of the palpebral rim, rim opening, levator function, an aesthetic balance of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months.
The axial chondro-mucosal flap was clinically viable in all patients. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm. levator function (mean 13 mm) was shown.
The authors discuss their complications and results and feel that this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstruction, for wide defects when the use of other flaps is compromised.
对超过一半的眼睑进行全层重建，主要是上眼睑，对外科医生来说是一项挑战。1992年，作者首次报道使用来自鼻部的轴型软骨黏膜瓣重建眼睑全层缺损的睑板结膜平面。本文报告并讨论了1991年6月至1997年3月期间采用上述技术进行手术的18例患者的随访结果。
除了肿瘤学评估外，还评估了以下参数：位置、闭合情况、溢泪情况、睑缘长度、睑缘开口、提上睑肌功能、眼睑的美学平衡以及供区并发症。随访时间为6至40个月。
轴型软骨黏膜瓣在所有患者中临床可行。1例患者出现2毫米的兔眼。静态参数在正常范围内。在上眼睑重建中，提上睑肌功能显示为8至18毫米（平均13毫米）。
作者讨论了他们的并发症和结果，并认为在专家手中，这种与全厚皮片联合使用的皮瓣，在复杂的全厚上眼睑重建中可被视为首选技术，在使用其他皮瓣受限的情况下，对于下眼睑的广泛缺损可能是一种替代方法。
