Zinkernagel Martin S, Catalano Elena, Ammann-Rauch Dagmar
Department of Ophthalmology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
Ophthalmic Plast Reconstr Surg. 2007 May-Jun;23(3):228-31. doi: 10.1097/IOP.0b013e318057797d.
We present the surgical outcome in a series of 4 patients with large full-thickness eyelid defects after basal cell carcinoma excision. The patients underwent reconstructive eyelid surgery using autogenous free tarsal grafts combined with a skin transposition flap from the upper eyelid. Two female and 2 male patients ranging in age from 44 years to 85 years were treated. In all 4 cases, posterior lamellae were reconstructed using a free tarsal graft, and the outer lamella was developed with a transposition skin flap from the upper eyelid. The skin flap provided adequate vascular support in all cases. Follow up of 10 months to 20 months showed a good outcome in all patients. Reconstruction of full thickness eyelid defects after extensive tumor excision requires reforming of the anterior and posterior lamella. Whereas the Hughes or Cutler Beard techniques for eyelid reconstruction require a 2-step approach with occlusion of the eye for at least 1 week, reconstruction with a free tarsal graft is a 1-stage procedure and does not entail eye occlusion. Autogenous tarsus as a free graft proves to be a simple procedure for posterior lamella substitution in lower eyelid surgery, especially in combination with a skin transposition flap from the upper eyelid.
我们报告了4例基底细胞癌切除术后出现大面积全层眼睑缺损患者的手术结果。这些患者接受了自体游离睑板移植联合上睑皮瓣转移的眼睑重建手术。治疗了2名女性和2名男性患者，年龄在44岁至85岁之间。在所有4例病例中，均使用游离睑板移植重建后层，并用来自上睑的转位皮瓣形成外层。皮瓣在所有病例中均提供了充足的血供支持。10个月至20个月的随访显示所有患者预后良好。广泛肿瘤切除术后全层眼睑缺损的重建需要重塑前后层。虽然用于眼睑重建的休斯或卡特勒·比尔德技术需要分两步进行，且眼睛需闭合至少1周，但游离睑板移植重建是一期手术，无需闭合眼睛。自体睑板作为游离移植在眼睑重建手术中是一种简单的后层替代方法，特别是与上睑皮瓣转移联合使用时。
