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采用改良的带睑板结膜移植的卡特勒-比尔德技术修复恶性肿瘤继发的上睑缺损

Reconstruction of Upper Eyelid Defects Secondary to Malignant Tumors with a Newly Modified Cutler-Beard Technique with Tarsoconjunctival Graft.

作者信息

Bengoa-González Álvaro, Laslău Bianca Ma, Martín-Clavijo Agustín, Mencía-Gutiérrez Enrique, Lago-Llinás Ma Dolores

机构信息

Ophthalmology Department, 12 de Octubre Hospital, Complutense University, 28041 Madrid, Spain.

Dermatology Department, Queen Elizabeth Hospital Birmingham, B15 2TH Birmingham, UK.

出版信息

J Ophthalmol. 2019 Mar 3;2019:6838415. doi: 10.1155/2019/6838415. eCollection 2019.

Abstract

PURPOSE

We describe a modification of Cutler-Beard's technique, using a contralateral tarsoconjunctival graft, in patients who underwent excision of large malignant tumors of the upper eyelid.

METHODS

This is an interventional retrospective review (clinical study) of ten cases, with age range from 64 to 86 years (mean: 71.2 years ± 6.49) with malignant upper eyelid tumors, operated by the same surgeon (AB-G), between 2011 and 2016. The resulting defects were reconstructed using a modification of Cutler-Beard's technique. A tarsoconjunctival graft was harvested from the contralateral upper eyelid, with an extra 3 mm of conjunctiva from the superior edge of tarsus and was attached to the upper eyelid defect, different from that previously described. Follow-up ranged between 24 and 60 months (mean: 41.6 ± 9.87). Functional, cosmetic outcomes and postoperative complications were evaluated.

RESULTS

No upper eyelid retraction, eyelid margin entropion, or graft retraction was observed in any of the cases. All of the patients were satisfied with the aesthetic result.

CONCLUSION

This technique allows us to safely inset a suitable graft on the ocular surface, with sufficient blood supply, resulting in a stable margin and good contour.

摘要

目的

我们描述了一种对卡特勒 - 比尔德技术的改良方法,即在接受上睑大恶性肿瘤切除的患者中使用对侧睑板结膜移植。

方法

这是一项对10例患者的介入性回顾性研究(临床研究),患者年龄在64至86岁之间(平均:71.2岁±6.49),患有上睑恶性肿瘤,于2011年至2016年间由同一位外科医生(AB - G)进行手术。使用改良的卡特勒 - 比尔德技术重建由此产生的缺损。从对侧上睑获取睑板结膜移植片,从睑板上缘额外取3毫米结膜,并将其附着于上睑缺损处,与先前描述的方法不同。随访时间为24至60个月(平均:41.6±9.87)。评估功能、美容效果和术后并发症。

结果

所有病例均未观察到上睑退缩、睑缘内翻或移植片退缩。所有患者对美学效果均满意。

结论

该技术使我们能够在眼表安全地植入合适的移植片,其血供充足,从而形成稳定的边缘和良好的轮廓。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/772a/6421748/abd0eca4373e/JOPH2019-6838415.001.jpg

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