Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
J Plast Reconstr Aesthet Surg. 2012 May;65(5):665-70. doi: 10.1016/j.bjps.2011.09.012. Epub 2011 Sep 22.
Treatment in malignant periorbital tumours requires a radical resection of the tumour, and reconstruction of eyelid defects is difficult task because it should aim at gaining functional and aesthetical improvement.
We have reviewed 50 cases of malignant periorbital tumour that were treated surgically from 1992 to 2010. We assessed the type of reconstruction performed, and present or absent of any complication.
The decision of the appropriate reconstructive procedure was based on the location of the tumour and the size of the defects. For the upper eyelid, switch flap from lower lid was performed in 11 out of 14 patients those defects exceeding 50% of the horizontal length. There were 21 complications (42%); major complications in 11 patients (22%) and minor complications in 10 patients (20%). Major complications have occurred only in upper eyelid or in lower eyelid. All of the major complications appeared in the patients with larger defects exceeding 50%.
The 72% of major complications were associated with reconstruction of larger defects in upper eyelid. It might be extremely difficult to obtain good results in the patients with large upper eyelid defects, although switch flap is applicable to such defects.
恶性眶周肿瘤的治疗需要彻底切除肿瘤，而眼睑缺损的重建是一项艰巨的任务，因为它应该旨在获得功能和美学上的改善。
我们回顾了 1992 年至 2010 年期间手术治疗的 50 例恶性眶周肿瘤患者。我们评估了所进行的重建类型，以及是否存在任何并发症。
适当的重建程序的决定是基于肿瘤的位置和缺损的大小。对于上眼睑，如果缺损超过水平长度的 50%，则在 14 例患者中有 11 例采用下眼睑的翻转皮瓣。有 21 例并发症（42%）；11 例患者出现严重并发症（22%），10 例患者出现轻微并发症（20%）。主要并发症仅发生在上眼睑或下眼睑。所有严重并发症都出现在缺损超过 50%的患者中。
72%的严重并发症与上眼睑较大缺损的重建有关。尽管翻转皮瓣适用于此类缺损，但对于上眼睑有较大缺损的患者，可能很难获得良好的效果。
