From the Department of Ophthalmology, Uludag University, Bursa.
Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Ophthalmic Plast Reconstr Surg. 2020 Jul/Aug;36(4):372-374. doi: 10.1097/IOP.0000000000001557.
To describe the reconstruction of large upper eyelid defects with bilobed flap and tarsoconjunctival graft.
The medical records of 5 patients who underwent upper eyelid tumor excision and eyelid reconstruction with a bilobed flap were reviewed. Various parameters, including demographic and clinical data, defect diameter, primary defect closure, complications, and follow-up time, were recorded. After tumor excision, the posterior lamella was reconstructed with an autologous tarsoconjunctival graft and anterior lamella with a superiorly based lateral bilobed flap.
All 5 patients (3 women, 2 men; age: 42-87 years) had malignant epidermal (n = 2) or adnexal (n = 3) tumors. Mean excisional defect diameter was between 18.5 and 25 mm. In all patients, the anterior lamellar defect was closed primarily with a bilobed flap. After surgery, a total of 4 complications occurred in 3 patients. One patient required orbital exenteration because of tumor recurrence. In the other patients, the functional and esthetic results were satisfactory. Follow-up time ranged from 4 to 102 months.
Lateral periorbital bilobed flap can be a good alternative for the single-stage reconstruction of large upper eyelid defects.
描述应用双叶皮瓣和睑板结膜移植重建大面积上睑缺损。
回顾了 5 例行上睑肿瘤切除和双叶皮瓣眼睑重建的患者的病历。记录了各种参数，包括人口统计学和临床数据、缺损直径、一期缺损闭合、并发症和随访时间。肿瘤切除后，用自体睑板结膜移植物重建后层，用带蒂外侧双叶皮瓣重建前层。
5 例患者（3 例女性，2 例男性；年龄：42-87 岁）均为恶性表皮（n=2）或附属器（n=3）肿瘤。平均切除缺损直径为 18.5-25mm。所有患者的前板层缺损均一期用双叶皮瓣闭合。术后共有 3 例 4 例患者发生并发症。1 例因肿瘤复发行眶内容剜除术。在其他患者中，功能和美容效果满意。随访时间 4-102 个月。
外侧眶周双叶皮瓣可作为一期重建大面积上睑缺损的良好选择。
