Department of plastic surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France.
Department of plastic surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France.
J Stomatol Oral Maxillofac Surg. 2018 Sep;119(4):268-273. doi: 10.1016/j.jormas.2018.03.001. Epub 2018 Mar 9.
Preserving the integrity of the eyelid margin in eyelid reconstruction remains a challenge for plastic surgeons. In 1976, Hübner described a technique to repair full-thickness eyelid defects using a tarsomarginal graft covered with a local flap. This simple technique addresses both functional and aesthetic requirements of eyelid reconstruction by using tissue from the contralateral eyelid. The aim of this study was to determine the appropriate role of this uncommon technique in eyelid reconstruction.
In total, 94 tarsomarginal grafts were performed on 70 patients. Eight surgeons participated in this study. Data were retrospectively collected from patients' charts and all information regarding surgical indications, histology, defect size and topography, operative time, immediate result, and potential complications were recorded.
Only one of the patients suffered total necrosis. Partial wound dehiscence occurred in one case and partial necrosis occurred in 6 cases. No major sequelae were observed in the donor eyelids. In 100% of cases, eyelid margin integrity was otherwise preserved. Four patients required revision surgery for insufficient malignancy resection and 13 patients for long-term eyelid ectropion or scar retraction.
This simple and reliable technique ensured the closure of full-thickness eyelid defects covering up to 3/4 of the eyelid length. The procedure should be more widely used as it guarantees high-quality eyelid reconstruction.
在眼睑重建中保持眼睑边缘的完整性仍然是整形外科医生面临的挑战。1976 年，Hübner 描述了一种使用睑缘皮瓣覆盖的睑板缘移植修复全层眼睑缺损的技术。这种简单的技术通过使用对侧眼睑的组织来满足眼睑重建的功能和美学要求。本研究旨在确定这种不常见技术在眼睑重建中的适当作用。
共有 70 名患者接受了 94 次睑板缘移植术。8 名外科医生参与了这项研究。从患者的病历中回顾性收集数据，记录了所有关于手术适应证、组织学、缺损大小和部位、手术时间、即刻结果和潜在并发症的信息。
只有 1 名患者发生全部坏死。1 例发生部分伤口裂开，6 例发生部分坏死。供区眼睑无明显后遗症。在所有病例中，眼睑边缘完整性均得以保留。4 例因恶性肿瘤切除不足需要再次手术，13 例因长期眼睑外翻或瘢痕回缩需要再次手术。
这种简单可靠的技术确保了全层眼睑缺损的闭合，覆盖了眼睑长度的 3/4 。由于该手术能保证高质量的眼睑重建，因此应该更广泛地应用。
