Hayashi Ayato, Mochizuki Mariko, Kamimori Tomoki, Horiguchi Masatoshi, Tanaka Rica, Mizuno Hiroshi
Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan.
Plast Reconstr Surg Glob Open. 2017 Feb 22;5(2):e1230. doi: 10.1097/GOX.0000000000001230. eCollection 2017 Feb.
Lower eyelid reconstruction after tumor removal is always challenging, and full-thickness defects beyond half of the eyelid length require a flap from a part other than the remaining lower eyelid, such as the temporal area or the cheek.
We aimed to report our experience of applying Smith-modified Kuhnt-Szymanowski, one of the most popular procedures for paralytic ectropion, for reconstructing oblong full-thickness lower eyelid margin defect.
We performed Smith-modified Kuhnt-Szymanowski on 5 cases of oblong full-thickness lower eyelid margin defect after skin cancer removal. The mean age of patients was 80.0 years. The horizontal widths of the defects ranged from half to two-thirds of the lower eyelid length and the vertical width ranged from 5 to 9 mm.
We obtained good functional and esthetic results in all cases. No patients developed ectropion or lower eyelid distortion, and all patients were satisfied with their results.
We utilized the procedure for morphological revision as a reconstructive procedure for eyelid margin defect by considering the defect as a morphological deformity of the eyelid margin; thus, donor tissue was not required to fill the defect and we could accomplish the reconstruction simply, firmly, and less invasively.
肿瘤切除术后下睑重建一直具有挑战性，超过睑裂长度一半的全层缺损需要取自剩余下睑以外部位的皮瓣，如颞部或颊部。
我们旨在报告应用史密斯改良库恩特-齐曼诺夫斯基法（治疗麻痹性睑外翻最常用的手术方法之一）重建长方形下睑全层边缘缺损的经验。
我们对5例皮肤癌切除术后出现长方形下睑全层边缘缺损的患者实施了史密斯改良库恩特-齐曼诺夫斯基法。患者的平均年龄为80.0岁。缺损的水平宽度为下睑长度的一半至三分之二，垂直宽度为5至9毫米。
所有病例均获得了良好的功能和美学效果。没有患者出现睑外翻或下睑变形，所有患者对其结果都很满意。
我们将形态修复手术用作睑缘缺损的重建手术，将缺损视为睑缘的形态畸形；因此，无需供体组织来填充缺损，我们能够简单、稳固且微创地完成重建。
