Robert M, Rousseau P, Arnaud D, Potier B, Hu W, Darsonval V
Service de chirurgie plastique reconstructrice et esthétique, CHU La Cavale-Blanche, boulevard Tanguy-Prigent, 29200 Brest, France.
Service de chirurgie plastique reconstructrice et esthétique, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
Ann Chir Plast Esthet. 2014 Aug;59(4):287-93. doi: 10.1016/j.anplas.2013.07.005. Epub 2013 Aug 30.
The external canthus defects with resection of the superior and inferior eyelids external portion remains difficult to treat. The reconstruction has to focus on both the reconstruction of the tarso-conjunctival plan and the musculo-cutaneous plan but has also to treat the disappearance of the external canthus. Usually the tarso-conjunctival plan is reconstructed by a septal transplant, conqual or of palatine mucous membrane. The technique presented here suggests to use two tarso-conjunctival transposition flaps to reconstruct the external canthus and the canthal external ligament. The palpebral defect is then pulled medialy, and is easily reconstructed by a Hübner's graft. The coverage of these tarso-conjunctival flaps and grafts is realized with local cutaneous or musculo-cutaneous flaps. The aim of this reconstruction is to allow a functional and aesthetic reconstruction with respected lid margins with eyelashes. Thanks to this technique, it is possible to reconstruct external canthus defects up to half of the superior and inferior eyelids.
上、下眼睑外侧部分切除后的外眦缺损仍然难以治疗。重建必须同时关注睑板结膜平面和肌皮平面的重建，而且还必须解决外眦消失的问题。通常，睑板结膜平面通过鼻中隔移植、结膜或腭黏膜进行重建。本文介绍的技术建议使用两个睑板结膜转位皮瓣来重建外眦和外眦韧带。然后将眼睑缺损向内侧牵拉，并通过许布纳移植很容易地进行重建。这些睑板结膜皮瓣和移植片通过局部皮瓣或肌皮瓣覆盖。这种重建的目的是在保留有睫毛的眼睑边缘的情况下实现功能和美学重建。借助该技术，可以重建高达上、下眼睑一半的外眦缺损。
