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眶重建中的帽状腱膜筋膜瓣:创新的取材技术。

The galea fascia flap in orbital reconstruction: innovative harvest technique.

作者信息

Zwahlen R A, Grätz K W, Obwegeser J A

机构信息

Department of Cranio-Maxillofacial Surgery, University Hospital of Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland.

出版信息

Eur J Surg Oncol. 2006 Sep;32(7):804-7. doi: 10.1016/j.ejso.2006.04.014. Epub 2006 Jun 9.

Abstract

AIM

To report the treatment of a recurrent adenoid-cystic carcinoma of the lacrimal gland required orbital exenteration with an en bloc resection of the lateral orbital rim and wall and an anterior portion of the temporal muscle. Reconstruction was planned with both the objectives of a shortened healing time for faster epithetic reconstruction and no visible scars.

METHOD

After a cranially extended temporal approach, the dissection of the superficial galea layer was connected with the subcutaneous dissection of the upper and lower eyelid after subciliary incisions.

RESULTS

Ample exposure of the temporal, frontal and orbital region was obtained, facilitating the orbital exenteration with en bloc resection of the lateral orbital rim and wall and the anterior portion of the temporal muscle. The epithelialization of the eye socket covered with the galea fascia flap was accelerated, providing faster epithetic reconstruction, without visible scars.

CONCLUSIONS

Healing time is accelerated, providing faster epithetic rehabilitation without visible scars, which is important in the postoperative rehabilitation ladder after eye exenteration for both patient and surgeon. Further more ablative surgery within this region gets safer and easier due to the ample exposure of this innovative surgical technique. Further evaluation of the effectiveness and safety of this new approach is advisable.

摘要

目的

报告一例复发性泪腺腺样囊性癌的治疗情况,该病例需行眼眶内容剜除术,并整块切除眶外侧缘和眶壁以及颞肌前部。重建手术旨在缩短愈合时间以实现更快的上皮修复且不留明显瘢痕。

方法

采用经颞部颅骨延伸入路,在睑缘下切口后,将帽状腱膜浅层的分离与上下眼睑的皮下分离相连。

结果

获得了颞部、额部和眼眶区域的充分暴露,便于进行眼眶内容剜除术,并整块切除眶外侧缘和眶壁以及颞肌前部。帽状腱膜筋膜瓣覆盖的眼眶上皮化加速,实现了更快的上皮修复,且无明显瘢痕。

结论

愈合时间加快,实现了更快的上皮修复且无明显瘢痕,这对患者和外科医生在眼球剜除术后的康复过程中都很重要。此外,由于这种创新手术技术提供了充分暴露,该区域的切除手术变得更安全、更容易。建议进一步评估这种新方法的有效性和安全性。

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