Fang Shuo, Yang Chao, Zhang Yuntong, Xue Chunyu, Bi Hongda, Dai Haiying, Xing Xin
From the Department of Plastic and Reconstruction, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, PR China (SF, CY, CX, HB, HD, XX); and Department of Emergency and Trauma, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, PR China (YZ).
Medicine (Baltimore). 2016 Jan;95(2):e2505. doi: 10.1097/MD.0000000000002505.
To describe a modified surgical procedure that uses a combination of the tarsoconjunctival flap, orbicularis myocutaneous advancement flap, and paranasal-island flap to correct extensive full-thickness lower eyelid defects in functioning eyes.From May 2010 to December 2013, a total of 15 patients had reconstructive surgeries of large to giant lower eyelid defect, with an average 19-month follow-up. The musculocutaneous flaps were harvested from both orbicularis and paranasal regions and clinical outcomes were recorded and analyzed.No major complications were observed in any of the patients. All the patients showed aesthetic eyelid contour, good color, and texture match as well as no obvious scar formation. The mean Marginal Reflex Distance-2 measured 4 months after surgery was 4.9 ± 0.4 mm.Reconstruction of a large defect in the lower eyelid with a tarsoconjunctival flap and the composite neighboring musculocutaneous flaps is a reliable and reproducible method. With proper design and well-executed precision, excellent functional and aesthetic results can be achieved by this elegant procedure without any major complications.
描述一种改良的手术方法，该方法联合使用睑板结膜瓣、眼轮匝肌肌皮推进瓣和鼻旁岛状瓣来矫正功能正常眼睛的广泛性全层下睑缺损。2010年5月至2013年12月，共有15例患者接受了大至巨大下睑缺损的重建手术，平均随访19个月。从眼轮匝肌和鼻旁区域获取肌皮瓣，并记录和分析临床结果。所有患者均未观察到严重并发症。所有患者的眼睑轮廓美观，颜色和质地匹配良好，且无明显瘢痕形成。术后4个月测量的平均边缘反射距离-2为4.9±0.4mm。使用睑板结膜瓣和复合相邻肌皮瓣重建下睑大缺损是一种可靠且可重复的方法。通过合理设计和精确操作，这种精细的手术可取得优异的功能和美学效果，且无任何严重并发症。
