Plastic and Reconstructive Surgery Department, Portuguese Institute of Oncology, Lisbon, Portugal.
J Plast Reconstr Aesthet Surg. 2010 Dec;63(12):2013-7. doi: 10.1016/j.bjps.2010.01.026. Epub 2010 Feb 18.
Upper eyelid tumours, particularly basal cell carcinomas, are relatively frequent. Surgical ablation of these lesions creates defects of variable complexity. Although several options are available for lower eyelid reconstruction, fewer surgical alternatives exist for upper eyelid reconstruction. Large defects of this region are usually reconstructed with two-step procedures. In 1997, Okada et al. described a horizontal V-Y myotarsocutaneous advancement flap for reconstruction of a large upper eyelid defect in a single operative time. However, no further studies were published regarding the use of this particular flap in upper eyelid reconstruction. In addition, this flap is not described in most plastic surgery textbooks. The authors report here their experience of 16 cases of horizontal V-Y myotarsocutaneous advancement flaps used to reconstruct full-thickness defects of the upper eyelid after tumour excision. The tumour histological types were as follows: 12 basal cell carcinomas, 2 cases of squamous cell carcinomas, 1 case of sebaceous cell carcinoma and 1 of malignant melanoma. This technique allowed closure of defects of up to 60% of the eyelid width. None of the flaps suffered necrosis. The mean operative time was 30 min. No additional procedures were necessary as good functional and cosmetic results were achieved in all cases. No recurrences were noted. In this series, the horizontal V-Y myotarsocutaneous advancement flap proved to be a technically simple, reliable and expeditious option for reconstruction of full-thickness upper eyelid defects (as wide as 60% of the eyelid width) in a single operative procedure. In the future this technique may become the preferential option for such defects.
上眼睑肿瘤，尤其是基底细胞癌，相对较为常见。这些病变的手术切除会导致不同程度的复杂性缺损。虽然下眼睑重建有多种选择，但上眼睑重建的手术选择较少。该区域的大缺损通常通过两步手术来重建。1997 年，Okada 等人描述了一种水平 V-Y 肌皮推进瓣，可在单次手术时间内重建大面积上眼睑缺损。然而，此后没有关于该特定皮瓣在上眼睑重建中应用的进一步研究。此外，该皮瓣在大多数整形外科教科书中并未提及。作者报告了他们使用水平 V-Y 肌皮推进瓣重建 16 例全层上眼睑肿瘤切除后缺损的经验。肿瘤的组织学类型如下：12 例基底细胞癌、2 例鳞状细胞癌、1 例皮脂腺癌和 1 例恶性黑色素瘤。该技术可闭合最大达 60%眼睑宽度的缺损。没有皮瓣发生坏死。平均手术时间为 30 分钟。所有病例均获得了良好的功能和美容效果，无需进行额外的手术。未观察到复发。在本系列中，水平 V-Y 肌皮推进瓣被证明是一种技术简单、可靠且快速的选择，可在单次手术中重建全层上眼睑缺损（最大可达 60%眼睑宽度）。在未来，这种技术可能成为此类缺损的首选。
