Cho Wonseok, Kim Chang Gyun, Jang Eun A, Kim Kyu Nam
Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea.
Face Plastic Surgery Clinic, Daejeon 35230, Republic of Korea.
Life (Basel). 2024 Feb 28;14(3):314. doi: 10.3390/life14030314.
Subciliary incision is a common approach for facial fracture surgery; however, it has a higher incidence of lower lid ectropion, which can be particularly challenging for beginning surgeons to manage. This study reports the usage of lateral tarsoplasty combined with a full-thickness skin graft (FTSG) to correct severe ectropion following the subciliary approach for infra-orbital rim fractures. We retrospectively reviewed all facial fracture cases involving infra-orbital rim fractures through a subciliary approach treated in our department between March 2021 and May 2023. Electronic medical records and clinical digital photographs of patients who met the inclusion criteria were reviewed. After reviewing 196 cases that used the subciliary approach, we found 6 patients (3.06%; 4 males and 2 females; mean age, 68.5 ± 4.89 years) with postoperative severe ectropion managed using lateral tarsoplasty and FTSG. The mean ectropion development and correction times after facial fracture surgery were 0.78 ± 0.24 and 0.91 ± 0.37 months, respectively. At the 12-month follow-up, all patients showed favorable outcomes, and the position of their lower eyelids was well maintained without ectropion recurrence. Based on these successful outcomes, lateral tarsoplasty combined with FTSG is proposed to be an effective and straightforward method for managing lower eyelid ectropion caused by facial fracture surgery.
睑缘下切口是面部骨折手术的常用入路;然而,其下睑外翻的发生率较高,这对于初入行的外科医生来说处理起来可能特别具有挑战性。本研究报告了采用外侧睑板成形术联合全厚皮片移植(FTSG)来矫正睑缘下切口治疗眶下缘骨折后出现的严重外翻。我们回顾性分析了2021年3月至2023年5月在我科采用睑缘下切口治疗的所有涉及眶下缘骨折的面部骨折病例。对符合纳入标准的患者的电子病历和临床数码照片进行了回顾。在回顾了196例采用睑缘下切口的病例后,我们发现6例患者(3.06%;4例男性和2例女性;平均年龄68.5±4.89岁)术后出现严重外翻,采用外侧睑板成形术和FTSG进行处理。面部骨折手术后外翻出现和矫正的平均时间分别为0.78±0.24个月和0.91±0.37个月。在12个月的随访中,所有患者均显示出良好的效果,其下眼睑位置保持良好,无外翻复发。基于这些成功的结果,外侧睑板成形术联合FTSG被认为是处理面部骨折手术引起的下睑外翻的一种有效且直接的方法。