Huggins Alison B, Latting Michelle W, Marx Douglas P, Giacometti Joseph N
Department of Ophthalmology, Thomas Jefferson University Hospital, Wills Eye Hospital, Philadelphia, Pennsylvania.
Department of Ophthalmology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Semin Plast Surg. 2017 Feb;31(1):22-30. doi: 10.1055/s-0037-1598190.
Although the majority of lesions present in the periocular region are benign, periocular cutaneous malignancies are certainly not uncommon and must be considered. The management of nonmelanoma cutaneous malignancies is predominately surgical with Mohs micrographic surgery or excision with frozen sections. The approach to reconstruction of the resulting defects depends on the defect location and size. When able, it is preferable to close lesions directly or with the recruitment of adjacent tissue in an effort to preserve the inherent anatomy. The eyelid's dynamic function is thus maintained, which is essential for optimal ocular surface protection. However, larger and more extensive defects will require complex reconstructions that are able to restore the necessary structural integrity to the eyelids. The authors review the various reconstruction approaches for defects of all sizes involving the periocular area including nonmarginal defects and defects of the lower and upper eyelids, as well as those of the medial canthal region.
尽管眼周区域出现的大多数病变是良性的，但眼周皮肤恶性肿瘤肯定并不罕见，必须予以考虑。非黑色素瘤皮肤恶性肿瘤的治疗主要是手术治疗，采用莫氏显微外科手术或冷冻切片切除。对由此产生的缺损进行修复的方法取决于缺损的位置和大小。如有可能，最好直接闭合病变或拉拢邻近组织，以保留固有的解剖结构。这样就能维持眼睑的动态功能，这对最佳的眼表保护至关重要。然而，更大、更广泛的缺损将需要复杂的修复，以恢复眼睑必要的结构完整性。作者回顾了涉及眼周区域各种大小缺损的不同修复方法，包括非边缘性缺损、上下眼睑缺损以及内眦区域缺损。
