Ogino Akihiro, Onishi Kiyoshi, Okada Emi, Nakamichi Miho
Department of Plastic and Reconstructive Surgery, Toho, University Omori Medical Center, Tokyo, Japan.
JPRAS Open. 2017 Sep 29;15:4-9. doi: 10.1016/j.jpra.2017.08.007. eCollection 2018 Mar.
It is often difficult to reconstruct comparatively large defects in the medial canthal region. The authors have performed reconstruction with multiple local flaps in 4 medial canthal defects after resection of malignant skin tumors.
The defects exceeded the medial canthal region, extending to the upper eyelid and the lower eyelid. The medial canthal defect was covered by transposition of a glabellar flap, the upper eyelid defect was covered by an upper eyelid myocutaneous advancement flap, and the lower eyelid defect was covered by a cheek rotation flap. Then the donor site of the glabellar flap was covered by a Rintala flap.
There was no recurrence in any of the cases, and good results were obtained. One case showed mild linear contracture, but the patient did not want corrective surgery.
This method is somewhat complicated compared to reconstruction with a single flap, but it is a combination of standard local flaps and is a simple reconstructive procedure. By adding additional resection, the suture line is consistent with the border of the facial unit, so postoperative scarring is inconspicuous. This technique is aesthetically useful because of the continuity of colour and texture resulting from the use of adjacent flaps.
内眦区域相对较大的缺损通常难以修复。作者对4例切除恶性皮肤肿瘤后的内眦缺损采用多种局部皮瓣进行修复。
缺损超出内眦区域，延伸至上睑和下睑。内眦缺损采用眉间皮瓣转移覆盖，上睑缺损采用上睑肌皮推进皮瓣覆盖，下睑缺损采用颊部旋转皮瓣覆盖。然后用林塔拉皮瓣覆盖眉间皮瓣的供区。
所有病例均无复发，效果良好。1例出现轻度线性挛缩，但患者不希望进行矫正手术。
与单皮瓣修复相比，该方法略显复杂，但它是标准局部皮瓣的组合，是一种简单的修复手术。通过增加额外切除，缝线与面部单元边界一致，因此术后瘢痕不明显。由于使用相邻皮瓣使颜色和质地连续，该技术在美学上具有实用性。
