Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, Lok Nayak Hospital, New Delhi, India.
J Craniofac Surg. 2022 May 1;33(3):e287-e290. doi: 10.1097/SCS.0000000000008146. Epub 2021 Sep 10.
To describe a series of medial canthal defect reconstruction by local/loco-regional flaps following excision of basal cell carcinoma.
A series of 35 medial canthal defects following excision of basal cell carcinoma was reconstructed by local/loco-regional flaps. For smaller defects, glabellar lateral advancement flap or Limberg's flap from the nasolabial area were used to resurface the defects. For larger defects extending to the upper and lower eyelid or to the nose, a combination of flaps, that is, forehead and cheek rotation flaps or glabellar and cheek rotation flaps were used.
In all the cases, the aesthetic and functional results were highly satisfactory except in one, where punctum and lower canaliculi were also excised with the tumor for clearance. This patient complained of watering from the affected eye. Two patients had developed webbing after the operation. It was corrected by Z plasty after 6 months.
Medial canthal defects are best managed by local/ loco-regional flaps. For smaller defects in the upper part, the glabellar flap is the choice of the flap and in the lower part, flaps from the nasolabial region give the best result. For larger defects not amenable to single flap, a combination of flaps (glabellar/forehead flap and cheek rotation flap) can close the defects with the good aesthetic and functional results.
描述基底细胞癌切除后采用局部/局部区域性皮瓣修复内眦缺陷的一系列方法。
采用局部/局部区域性皮瓣对 35 例基底细胞癌切除后内眦缺陷进行了修复。对于较小的缺损，采用眉间外侧推进皮瓣或鼻唇区域的 Limberg 皮瓣来覆盖缺损。对于较大的缺损，累及上、下眼睑或鼻子的缺损，采用皮瓣联合，即额部和颊部旋转皮瓣或眉间和颊部旋转皮瓣。
所有病例的美学和功能效果均非常满意，除了 1 例因肿瘤清除而同时切除了泪小点和下泪小管的患者，该患者主诉患眼流泪。2 例患者术后出现了粘连，术后 6 个月行 Z 成形术矫正。
内眦缺陷最好采用局部/局部区域性皮瓣进行修复。对于上半部分较小的缺损，眉间皮瓣是首选皮瓣，而下半部分，鼻唇区域的皮瓣能获得最佳效果。对于不能用单个皮瓣修复的较大缺损，可以采用皮瓣联合（眉间/额部皮瓣和颊部旋转皮瓣）来闭合缺损，获得良好的美学和功能效果。
