Keçeci Yavuz, Bali Zulfukar Ulas, Ahmedov Anvar, Yoleri Levent
Department of Plastic and Reconstructive Surgery, Manisa Celal Bayar University, Manisa, Turkey.
Department of Plastic and Reconstructive Surgery, Evliya Çelebi Hospital, Kütahya, Turkey.
J Plast Surg Hand Surg. 2020 Feb;54(1):1-5. doi: 10.1080/2000656X.2019.1647851. Epub 2019 Aug 5.
Eyelid reconstruction is a challenging surgical procedure because of the special function and structure of the eyelids. There are various useful techniques which can be used to reconstruct eyelid defects. In this report, the authors aimed to present the clinical results of angular artery-based island flap for the repair of the full thickness eyelid defects. This presented series consists of eight patients with full-thickness eyelid defects. Oncologic resection was the reason for all of them. Five of the patients had lower eyelid defects and the other three had upper eyelid defects. Nasojugal angular artery-based axial flap was used in reconstruction in all patients. The inferior limit of the flap was the alar rim level in order to make the flap totally axial. A tunnel was created under the orbicularis oculi muscle in cases where the medial portion of the eyelids was left intact and healthy. Septal chondromucosal graft was used to repair posterior lamella of the eyelid. The follow-up period of the cases was from 12 months to 22 months, with a mean follow-up period of 16 months. There was only one patient with reconstructed upper eyelid needed flap defatting. There was no ectropion or wound healing problem observed during the follow-up period. This presented series shows that angular artery-based axial flap and septal chondromucosal graft combination is a simple and safe technique for both upper and lower eyelid full-thickness defect reconstruction. The donor site of this flap heals with an inconspicuous scar concealed in the nasojugal area.
由于眼睑的特殊功能和结构，眼睑重建是一项具有挑战性的外科手术。有多种有用的技术可用于重建眼睑缺损。在本报告中，作者旨在展示以角动脉为基础的岛状皮瓣修复全层眼睑缺损的临床结果。本系列报告包括8例全层眼睑缺损患者。所有患者均因肿瘤切除导致眼睑缺损。其中5例为下眼睑缺损，另外3例为上眼睑缺损。所有患者均采用鼻颧角动脉为蒂的轴型皮瓣进行重建。为使皮瓣完全成为轴型皮瓣，皮瓣的下缘为鼻翼缘水平。在眼睑内侧部分保持完整且健康的情况下，在眼轮匝肌下创建一个隧道。采用鼻中隔软骨黏膜移植修复眼睑后层。病例随访时间为12个月至22个月，平均随访时间为16个月。仅1例重建上眼睑的患者需要进行皮瓣去脂。随访期间未观察到睑外翻或伤口愈合问题。本系列报告表明，以角动脉为基础的轴型皮瓣与鼻中隔软骨黏膜移植相结合是一种用于上下眼睑全层缺损重建的简单且安全的技术。该皮瓣的供区愈合后在鼻颧区域留下不明显的瘢痕。
