Sarfaty Havi, Ezra-Elia Raaya, Kahane Nili, Sandalon Shai, Segev Yifat, Sebbag Lionel
EYECARE Clinic, Yehud-Monosson, Israel.
Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Vet Ophthalmol. 2023 Mar;26(2):121-127. doi: 10.1111/vop.13070. Epub 2023 Mar 5.
To describe the surgical technique and clinical outcomes of the glabellar flap and its modification for the reconstruction of the medial canthus following resection of tumors in three dogs and two cats.
Three dogs (7-, 7-, and 12.5-year-old mixed breeds) and two cats (10- and 14-year-old Domestic shorthair) presented with a 7-13 mm tumor affecting the eyelid and/or conjunctiva in the medial canthal region. Following en bloc mass excision, an inverted V-shaped skin incision was made in the glabellar region (i.e., the area between the eyebrows in humans). The apex of the inverted V-shaped flap was rotated in three cases, whereas a horizontal sliding movement was performed in the other two cases to better cover the surgical wound. The surgical flap was then trimmed to fit the surgical wound and sutured in place in two layers (subcutaneous and cutaneous).
Tumors were diagnosed as mast cell tumors (n = 3), amelanotic conjunctival melanoma (n = 1), and apocrine ductal adenoma (n = 1). No recurrence was noted in a follow-up time of 146 ± 84 days. Satisfactory cosmetic outcome with normal eyelids closure was achieved in all cases. Mild trichiasis was present in all patients and mild epiphora was noted in 2/5 patients, but there were no associated clinical signs such as discomfort or keratitis.
The glabellar flap was easy to perform and provided a good outcome in terms of cosmetic, eyelid function, and corneal health. Postoperative complications from trichiasis appear to be minimized by the presence of the third eyelid in this region.
描述眉间皮瓣及其改良术式在三只犬和两只猫内眦肿瘤切除术后重建内眦的手术技术及临床效果。
三只犬(7岁、7岁和12.5岁的混血品种)和两只猫(10岁和14岁的家猫),内眦区域的眼睑和/或结膜出现7 - 13毫米的肿瘤。整块肿物切除后,在眉间区域(即人类两眉之间的区域)做倒V形皮肤切口。3例将倒V形皮瓣的尖端旋转,另外2例进行水平滑动以更好地覆盖手术创面。然后修剪手术皮瓣以适应手术创面,并分两层(皮下和皮肤)缝合到位。
肿瘤诊断为肥大细胞瘤(n = 3)、无色素性结膜黑色素瘤(n = 1)和顶泌汗腺导管腺瘤(n = 1)。在146±84天的随访期内未发现复发。所有病例均获得满意的美容效果,眼睑闭合正常。所有患者均有轻度倒睫,2/5患者有轻度溢泪,但无不适或角膜炎等相关临床症状。
眉间皮瓣操作简便,在美容、眼睑功能和角膜健康方面效果良好。该区域第三眼睑的存在似乎将倒睫引起的术后并发症降至最低。