Case Western Reserve University, School of Medicine, Cleveland, Ohio.
Oculofacial Plastic Surgery, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.
Ophthalmic Plast Reconstr Surg. 2022;38(6):583-587. doi: 10.1097/IOP.0000000000002215. Epub 2022 May 13.
To determine the safety and effectiveness of a biplanar-pivoted V-Y flap design in reconstructing medial canthal defects of all sizes.
Retrospective review of patients who underwent repair of medial canthal region defects with the biplanar-pivoted V-Y flap from January 2016 to May 2021. Variables collected included age, gender, surgical indication, defect sizes and location, flap(s) and/or graft(s) used, and follow-up time. Outcome measures included complications, patient satisfaction with cosmesis, ability to close the defect with minimal wound tension, and additional surgeries.
Eighteen cases of medial canthal, nasal sidewall, and nasojugal fold area reconstruction were performed using a biplanar-pivoted V-Y flap in 18 patients. The cohort included 7 males and 11 females with a mean age of 72.4 years (range, 52-92 years) and mean follow-up time of 4.4 months (range, 1-14 months). Mean defect size was 2.0 × 1.4 cm (range, 0.5-5.5 cm). Eight patients received concomitant full-thickness skin grafts, five patients underwent simultaneous rotational flap repair, one patient underwent simultaneous nasoglabellar myocutaneous flap repair, and one patient received a simultaneous traditional, nonbiplanar V-Y plasty of the upper eyelid. All defects were closed with no wound tension. No cases of infection, hemorrhage, or wound dehiscence occurred during follow-up. Complications included mild ectropion (2 patients) and mild tip necrosis (1 patient). No patients elected for reoperation. No trapdoor deformity was observed. No patients underwent reoperation for local tumor recurrence.
The extended mobility of the biplanar-pivoted V-Y flap provides excellent closure of defects involving the medial canthal region with minimal surgical complications.
确定双平面旋转 V-Y 皮瓣设计用于重建各种大小的内眦缺损的安全性和有效性。
回顾性分析 2016 年 1 月至 2021 年 5 月期间采用双平面旋转 V-Y 皮瓣修复内眦区缺损的患者。收集的变量包括年龄、性别、手术指征、缺损大小和位置、使用的皮瓣和/或移植物以及随访时间。观察指标包括并发症、患者对美容效果的满意度、以最小的伤口张力闭合缺损的能力以及是否需要进行额外手术。
18 例患者共 18 例，采用双平面旋转 V-Y 皮瓣对内眦、鼻侧壁和鼻颊皱襞区进行重建，其中男 7 例，女 11 例，平均年龄 72.4 岁（52-92 岁），平均随访时间 4.4 个月（1-14 个月）。缺损平均大小为 2.0×1.4cm（0.5-5.5cm）。8 例患者同时接受全厚皮片移植，5 例患者同时接受旋转皮瓣修复，1 例患者同时接受鼻额肌皮瓣修复，1 例患者同时接受传统非双平面上睑 V-Y 成形术。所有缺损均无张力闭合。随访期间无感染、出血或伤口裂开。并发症包括轻度外翻（2 例）和轻度鼻尖坏死（1 例）。无患者选择再次手术。未观察到活瓣畸形。无患者因局部肿瘤复发而行再次手术。
双平面旋转 V-Y 皮瓣的可扩展性良好，可提供出色的内眦区缺损闭合效果，手术并发症少。
