Jordan D R, Tse D T, Anderson R L, Hansen S O
Oculoplastic, Lacrimal, and Orbital Service, University of Ottawa, Ontario, Canada.
Ophthalmic Plast Reconstr Surg. 1990;6(3):158-67.
Reconstruction of full thickness eyelid defects requires the correction of both posterior lamella (tarsus, conjunctiva) and anterior lamella (skin, muscle). Tarsal substitutes including banked sclera, nasal cartilage, ear cartilage, and periosteum can be beneficial for posterior lamellar repair, while anterior lamellar replacement, including skin grafts, pedicle flaps, advancement flaps, etc., is important to cover the posterior reconstructed portion. At times, due to extensive tissue loss, the eyelid reconstruction can be particularly challenging. We have found an alternative posterior lamellar reconstructive technique utilizing irradiated homologous tarsal plate that can be particularly useful in selected cases of severe tissue loss. The experimental surgical procedure in monkeys and the histological fate of the implanted tarsus is described in Part I, and followed in Part II by our experience with this tissue in six human patients.
全层眼睑缺损的重建需要同时修复后层(睑板、结膜)和前层(皮肤、肌肉)。包括保存巩膜、鼻软骨、耳软骨和骨膜在内的睑板替代物对后层修复可能有益,而包括皮肤移植、带蒂皮瓣、推进皮瓣等在内的前层替代物对于覆盖重建后的后层部分很重要。有时,由于广泛的组织缺失,眼睑重建可能特别具有挑战性。我们发现了一种利用经辐照的同种异体睑板的后层重建替代技术,该技术在某些严重组织缺失的病例中可能特别有用。第一部分描述了在猴子身上进行的实验性手术过程以及植入睑板的组织学转归,第二部分介绍了我们在六名人类患者中使用这种组织的经验。