Ito Riri, Maeda Taku, Yamamoto Yuhei, Funayama Emi, Murao Naoki, Osawa Masayuki, Ishikawa Kosuke, Ikeda Masaki, Hayashi Toshihiko
Faculty of Medicine and Graduate School of Medicine, Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo.
Department of Plastic and Reconstructive Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
J Craniofac Surg. 2019 Nov-Dec;30(8):2614-2616. doi: 10.1097/SCS.0000000000005944.
Reconstruction of upper eyelid defects should aim for a moveable lid with perfect corneal protection and good aesthetic quality. Numerous procedures to reconstruct large upper eyelid defects have been reported, but these methods require 2-stage procedures. A new method for reconstructing full-thickness upper eyelid defects after tumor excision in a single stage was presented in this study. The preferred technique uses excess skin as an advancement flap together with an ear cartilage graft for the lining. Reconstruction was performed with an advancement flap using excess skin and ear cartilage for full-thickness defects after upper eyelid tumor excision. The rectangular flap was outlined on the excess skin of the upper eyelid. After tumor resection of the full-thickness defect, the ear cartilage was sutured to the remaining tarsus. The residual levator aponeurosis and posterior lamellar were connected to the transplanted ear cartilage. The outer layer was reconstructed with an advancement rectangular flap. The authors performed this technique for 4 patients, aged 62 to 88 years, for upper eyelid reconstruction. Good functional and aesthetic results were achieved for all patients. Our method involves a single-stage reconstruction, which is simpler and less invasive than other techniques.
上睑缺损的重建应旨在实现具有完美角膜保护和良好美学质量的可活动眼睑。已有许多报道用于重建大型上睑缺损的手术方法，但这些方法需要分两期进行。本研究提出了一种在肿瘤切除后一期重建全层上睑缺损的新方法。首选技术是将多余皮肤作为推进皮瓣，并使用耳软骨移植作为衬里。采用推进皮瓣联合耳软骨对眼睑肿瘤切除后的全层缺损进行重建。在上睑多余皮肤上画出矩形皮瓣。在切除全层缺损的肿瘤后，将耳软骨缝合到剩余的睑板上。将残余的提上睑肌腱膜和后层与移植的耳软骨相连。外层用推进矩形皮瓣重建。作者对4例年龄在62至88岁的患者采用该技术进行上睑重建。所有患者均取得了良好的功能和美学效果。我们的方法是一期重建，比其他技术更简单且侵入性更小。
