Huang Ze-Chun, Yan Dan, Huang Li-Fang, Yang Hao-Yan, He Bin, Zhang An-Li, Li Shuai-Hua
Department of Cosmetic and Plastic Surgery, The First People's Hospital of Chenzhou, Chenzhou, China.
School of Basic Medicine, Naval Medical University, Shanghai, China.
Front Surg. 2022 Aug 12;9:786370. doi: 10.3389/fsurg.2022.786370. eCollection 2022.
To introduce a new surgical method for the repair of a large inner canthus combined with tissue loss at the inner canthal angle of the eye by using a bird-beak-type z-shaped asymmetrical flap and to summarize its clinical effect.
A total of 56 patients with a large inner canthus were randomly selected, and a bird-beak-type z-shaped asymmetrical flap was used on the nasal side of the lower eyelid to repair and reconstruct the inner canthal folds. The inner canthal point was located according to physiological aesthetics. The short and long arms of the z-shaped asymmetrical flap were separated, replaced, fixed, and shaped to reconstruct the skin folds of the inner canthus and restore its aesthetic morphology.
All incisions after surgery achieved primary healing, and all 56 cases were followed up for 6-20 months (average 8.6 months). The caruncula lacrimalis was moderately exposed, the inner canthal angles possessed a natural appearance, and the results of the surgery were satisfactory. Five patients developed scar hyperplasia within one month after surgery, and arnica gel was applied topically for 3-6 months until the scar faded or disappeared, but no obvious scars were seen in the surgical area of the remaining patients. In two patients, the internal canthi were asymmetrical, but this improved after adjustment.
Repair of a large inner canthus and tissue loss at the inner canthal angle of the eye using a bird-beak-type z-shaped asymmetrical flap is a simple operation, resulting in minimal trauma. Postoperatively, the inner canthal angle possessed a natural appearance with no obvious scarring.
介绍一种采用鸟喙型Z形不对称皮瓣修复内眦开大伴内眦角组织缺损的新手术方法，并总结其临床效果。
随机选取56例内眦开大患者，在下睑鼻侧采用鸟喙型Z形不对称皮瓣修复并重建内眦皱襞。根据生理美学定位内眦点。分离、置换、固定并塑形Z形不对称皮瓣的短臂和长臂，以重建内眦皮肤皱襞并恢复其美学形态。
术后所有切口均一期愈合，56例均随访6～20个月（平均8.6个月）。泪阜适度外露，内眦角外观自然，手术效果满意。5例患者术后1个月内出现瘢痕增生，局部外用山金车凝胶3～6个月，直至瘢痕消退或消失，其余患者手术区域未见明显瘢痕。2例患者内眦不对称，但经调整后有所改善。
采用鸟喙型Z形不对称皮瓣修复内眦开大及内眦角组织缺损手术操作简单，创伤极小。术后内眦角外观自然，无明显瘢痕形成。
