Shin Hye-Young, Chu Miyoung, Kim Ji Hyun, Paik Ji-Sun, Yang Suk-Woo
Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Craniofac Surg. 2019 Oct;30(7):2181-2183. doi: 10.1097/SCS.0000000000005732.
To report long-term surgical outcomes of Cutler-Beard reconstructive surgery in patients with large full-thickness upper eyelid defects following malignant tumor excision.
The medical records of 5 consecutive patients with full-thickness upper eyelid defects following tumor resection who underwent Cutler-Beard surgery were reviewed retrospectively between April 2005 and November 2018. Surgical procedure comprises 2 stages: first, complete tumor resection followed by bridged full-thickness lower eyelid advancement flap; second, separation of the closed eyelid with eyelid margin repair 7 to 9 weeks later. Postoperative anatomical, functional and cosmetic outcomes, and complications were evaluated during follow-up at 22 to 77 months.
Patients were in the age group of 49 to 75 years, including 3 (60%) females and 2 (40%) males. Three of the 5 patients (60%) exhibited sebaceous cell carcinoma and 2 (40%) showed squamous cell carcinoma. Three patients (60%) underwent Cutler-Beard surgery after recurrence of primary carcinoma following previous operation. Three patients underwent revision surgery with entropion, 2 underwent correction for wound dehiscence and 1 was treated with symblepharon lysis. No serious or permanent ocular complications were observed during the operation or follow-up with the patients. The procedure resulted in good aesthetic quality and acceptable sequelae at the donor site.
Cutler-Beard procedure for the reconstruction of large and full-thickness upper eyelid defects is an effective procedure with satisfactory long-term results, although a few patients may require minor revision surgery.
报告卡特勒 - 比尔德重建手术治疗恶性肿瘤切除术后上睑全层大缺损患者的长期手术效果。
回顾性分析2005年4月至2018年11月期间连续5例行卡特勒 - 比尔德手术的肿瘤切除术后上睑全层缺损患者的病历。手术过程包括两个阶段：第一，完整切除肿瘤，随后行桥式全层下睑推进皮瓣；第二，7至9周后分离闭合的眼睑并修复睑缘。在22至77个月的随访期间评估术后的解剖学、功能和美容效果以及并发症。
患者年龄在49至75岁之间，其中女性3例（60%），男性2例（40%）。5例患者中有3例（60%）为皮脂腺癌，2例（40%）为鳞状细胞癌。5例患者中有3例（60%）在先前手术的原发性癌复发后行卡特勒 - 比尔德手术。3例患者因睑内翻接受了修复手术，2例因伤口裂开接受了矫正，1例因睑球粘连溶解接受了治疗。手术过程中及随访期间未观察到患者出现严重或永久性眼部并发症。该手术在供区产生了良好的美学效果和可接受的后遗症。
卡特勒 - 比尔德手术用于重建上睑全层大缺损是一种有效的手术方法，长期效果令人满意，尽管少数患者可能需要进行小的修复手术。
