Perry Julian D, Taban Mehryar
Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Ophthalmic Plast Reconstr Surg. 2009 Jul-Aug;25(4):276-9. doi: 10.1097/IOP.0b013e3181ac76dd.
To evaluate the use of a superiorly based bilobed flap for reconstruction of nasojugal fold region defects.
Retrospective review of all patients undergoing medial canthal, nasal sidewall, and nasojugal fold region reconstruction using a superiorly based bilobed flap from October 2000 through March 2008. Charts were reviewed for patient age and gender, indication, defect size and location, flap(s) used, and follow-up time. Outcome measures included ability to completely close the defect with minimal tension, cosmetic appearance, complications, and need for further surgery.
Eighteen cases of medial canthal and nasojugal fold area reconstruction were performed using a superiorly based bilobed flap in 17 patients. There were 8 male and 9 female patients with an average age of 68.2 years (range, 11-88 years) and mean follow-up time of 17.8 months (range, 1-60 months). Mean defect size measured 2.0 x 1.4 cm (range, 0.7-4 cm). One patient underwent simultaneous glabellar flap repair, 2 patients underwent simultaneous lateral lower eyelid rotational flap repair, and 1 patient underwent simultaneous upper eyelid V-Y advancement flap. All defects closed completely with no wound tension. No cases of hemorrhage, infection, dehiscence, or necrosis developed during the follow-up period. Cosmetic satisfaction occurred in 16 of 17 patients. Complications included mild medial ectropion (2 patients) and canalicular stenosis (1 patient). None of these patients elected reoperation. Trapdoor deformity did not occur in any case. Two patients underwent reoperation for local tumor recurrence.
A superiorly based bilobed flap adequately reconstructs inferior medial canthal, nasal sidewall, and nasojugal fold defects.
评估以近端为蒂的双叶皮瓣用于鼻颧沟区域缺损修复的效果。
回顾性分析2000年10月至2008年3月期间，所有采用以近端为蒂的双叶皮瓣进行内眦、鼻侧壁及鼻颧沟区域修复的患者。查阅病历，记录患者的年龄、性别、手术指征、缺损大小及位置、所采用的皮瓣、随访时间。评估指标包括：以最小张力完全闭合缺损的能力、外观、并发症以及再次手术的必要性。
17例患者共18次采用以近端为蒂的双叶皮瓣进行内眦及鼻颧沟区域修复。其中男性8例，女性9例，平均年龄68.2岁（范围11 - 88岁），平均随访时间17.8个月（范围1 - 60个月）。平均缺损大小为2.0×1.4 cm（范围0.7 - 4 cm）。1例患者同期行眉间皮瓣修复，2例患者同期行下睑外侧旋转皮瓣修复，1例患者同期行上睑V - Y推进皮瓣修复。所有缺损均完全闭合，无伤口张力。随访期间未发生出血、感染、裂开或坏死病例。17例患者中有16例对外观满意。并发症包括轻度内眦外翻（2例）和泪小管狭窄（1例）。这些患者均未选择再次手术。无一例发生活板门畸形。2例患者因局部肿瘤复发接受再次手术。
以近端为蒂的双叶皮瓣能充分修复内眦下、鼻侧壁及鼻颧沟缺损。
