Maghsodnia Gholamreza, Ebrahimi Ali, Arshadi Amirabbas
Razi Skin Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Craniofac Surg. 2011 Mar;22(2):606-8. doi: 10.1097/SCS.0b013e318207f2b5.
Many techniques have been described for correcting ectropion, but when the ectropion follows skin cancer excision, only a technique that replaces missing skin should be used. The bipedicled Tripier flap tends to give some excess bulk at each end but gives an excellent correction of ectropion. The aim of this study was to apply musculocutaneous bipedicled Tripier flap from upper lid for correction of ectropion due to previous excision of lower-lid malignancies and evaluate its outcome. This was a prospective case-series study. In this study, 15 patients (6 women, 9 men), ranging from 35 to 72 years old (mean, 51 years) underwent operation with Tripier flap for reconstruction of ectropion because of basal cell carcinoma (BCC) resection. In patients with ectropion, Tripier flap with or without ear or nasal septal cartilage was used for reconstruction of deformities 3 months after lower-lid reconstruction with local flaps. All patients were satisfied, and ectropion was corrected in all cases. There were no complications such as dry eye or corneal abrasion after operation. Also, we had not any case of ischemic flap. We suggest that Tripier flap is one of the best methods for reconstruction of lower-lid retraction or ectropion. This is a desirable method, functionally and aesthetically.
已经描述了许多用于矫正睑外翻的技术，但当睑外翻继发于皮肤癌切除术后时，应仅采用一种能替代缺失皮肤的技术。双蒂特里皮尔皮瓣（Tripier flap）两端往往会有一些多余的组织，但对睑外翻的矫正效果极佳。本研究的目的是应用上睑肌皮双蒂特里皮尔皮瓣来矫正因先前下睑恶性肿瘤切除所致的睑外翻，并评估其效果。这是一项前瞻性病例系列研究。在本研究中，15例患者（6例女性，9例男性），年龄在35至72岁之间（平均51岁），因基底细胞癌（BCC）切除后行特里皮尔皮瓣手术来重建睑外翻。对于睑外翻患者，在使用局部皮瓣进行下睑重建3个月后，采用带或不带耳软骨或鼻中隔软骨的特里皮尔皮瓣来重建畸形。所有患者均满意，所有病例的睑外翻均得到矫正。术后未出现干眼或角膜擦伤等并发症。此外，我们也没有出现皮瓣缺血的病例。我们认为特里皮尔皮瓣是重建下睑退缩或睑外翻的最佳方法之一。从功能和美学角度来看，这都是一种理想的方法。
