Guyuron B
Adv Ophthalmic Plast Reconstr Surg. 1992;9:143-57.
Based on the pathology of the eye socket and periorbital deficiencies, three distinct classes of patients can be recognized: I. Those who solely have eye socket deficiency with normal orbital and periorbital tissue. The suggested surgical treatment for this class of patient would be a skin or mucosa graft. II. Patients who have inadequate lining, as well as orbital volume deficiency. The preferred reconstructive approach includes cartilage (rib or ear) with or without fat graft, and skin or mucosa grafts for eye socket expansion. III. For failed reconstructions of classes I and II or for patients with severe orbital and periorbital deficiencies, the choice is one of three flaps: If the superficial temporal vessels and the postauricular skin is intact, the ideal flap is postauricular fasciocutaneous. If the postauricular skin has previously been used yet the superficial vasculature is intact, a secondary flap is the better choice. In cases where both postauricular skin and superficial temporal vessels have been sacrificed the recommended flap is a free flap with microvascular anastomosis.
根据眼眶及眶周缺损的病理情况，可识别出三类不同的患者：I. 仅存在眼眶缺损但眼眶及眶周组织正常的患者。这类患者建议的手术治疗方法是皮肤或黏膜移植。II. 存在衬里不足以及眼眶容积缺损的患者。首选的重建方法包括使用软骨（肋软骨或耳软骨），可伴有或不伴有脂肪移植，以及用于眼眶扩张的皮肤或黏膜移植。III. 对于I类和II类重建失败的患者或存在严重眼眶及眶周缺损的患者，可选择以下三种皮瓣之一：如果颞浅血管和耳后皮肤完整，理想的皮瓣是耳后筋膜皮瓣。如果耳后皮肤先前已被使用但浅部血管系统完整，二次皮瓣是更好的选择。在耳后皮肤和颞浅血管均已受损的情况下，推荐的皮瓣是带微血管吻合术的游离皮瓣。
