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恶性眼睑肿瘤切除术后的重建技术——我们的经验

Reconstructive Techniques Following Malignant Eyelid Tumour Excision-Our Experience.

作者信息

Gąsiorowski Krzysztof, Gontarz Michał, Bargiel Jakub, Marecik Tomasz, Szczurowski Paweł, Wyszyńska-Pawelec Grażyna

机构信息

Department of Cranio-Maxillofacial Surgery, Medical College, Jagiellonian University, 30-688 Cracow, Poland.

出版信息

J Clin Med. 2024 Oct 14;13(20):6120. doi: 10.3390/jcm13206120.

DOI:10.3390/jcm13206120
PMID:39458069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11508535/
Abstract

: Malignant eyelid tumours present a considerable challenge in the field of ophthalmic oncology, necessitating a combination of precision oncological care and meticulous reconstruction to ensure the preservation of eyelid functionality and the maintenance of facial aesthetics. : This study presents a review of the outcomes of 167 patients who underwent eyelid reconstruction following the excision of primary non-melanocytic malignant tumours. The choice of reconstruction technique was dependent on a number of factors, including the stage of the tumour, its location, and the characteristics of the patient. The most commonly used techniques included regional flaps, local flaps, and skin grafts. The most frequently employed reconstruction techniques were forehead flaps (59 cases), simple excisions (38 cases), and Mustarde cheek flaps (16 cases). : The postoperative complications, including ectropion, epiphora, and flap necrosis, were recorded. However, no significant correlation was found between the risk of complications and either the location of the tumour or the reconstruction method employed. Despite the complexity of medial canthal and lower eyelid reconstruction, satisfactory aesthetic and functional outcomes were generally achieved. : This study emphasises the importance of individualised surgical planning, highlighting the advantages and limitations of various techniques to optimise both the functional and aesthetic results.

摘要

恶性眼睑肿瘤在眼科肿瘤学领域构成了相当大的挑战,需要精准的肿瘤治疗与细致的重建相结合,以确保保留眼睑功能并维持面部美观。

本研究回顾了167例原发性非黑素细胞性恶性肿瘤切除术后接受眼睑重建患者的治疗结果。重建技术的选择取决于多种因素,包括肿瘤分期、位置以及患者特征。最常用的技术包括区域皮瓣、局部皮瓣和皮肤移植。最常采用的重建技术是额部皮瓣(59例)、单纯切除术(38例)和Mustarde颊部皮瓣(16例)。

记录了术后并发症,包括睑外翻、溢泪和皮瓣坏死。然而,未发现并发症风险与肿瘤位置或所采用的重建方法之间存在显著相关性。尽管内眦和下眼睑重建较为复杂,但总体上获得了满意的美学和功能效果。

本研究强调了个体化手术规划的重要性,突出了各种技术的优缺点,以优化功能和美学效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/359ac018403b/jcm-13-06120-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/054c2dedb1dd/jcm-13-06120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/e30005f8ca68/jcm-13-06120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/5af432ee242e/jcm-13-06120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/359ac018403b/jcm-13-06120-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/054c2dedb1dd/jcm-13-06120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/e30005f8ca68/jcm-13-06120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/5af432ee242e/jcm-13-06120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d88/11508535/359ac018403b/jcm-13-06120-g004.jpg

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本文引用的文献

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Int J Mol Sci. 2024 Jun 27;25(13):7056. doi: 10.3390/ijms25137056.
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Complications and Recurrences after Excision and Reconstruction of Eyelid Tumours.眼睑肿瘤切除与重建术后的并发症和复发。
Curr Oncol. 2024 Mar 22;31(4):1713-1724. doi: 10.3390/curroncol31040130.
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Commentary: Dynamic Upper Eyelid Reconstruction for Total Periorbital Soft Tissue Loss.评论:用于全眶周软组织缺损的动态上睑重建术
Arch Plast Surg. 2024 Feb 22;49(3):V2. doi: 10.1055/s-0043-1777240. eCollection 2022 May.
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Risk Factors for Orbital Invasion in Malignant Eyelid Tumors, Is Orbital Exenteration Still Necessary?恶性眼睑肿瘤眼眶侵犯的危险因素,眼眶内容剜除术是否仍有必要?
J Clin Med. 2024 Jan 26;13(3):726. doi: 10.3390/jcm13030726.
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Customized Reconstruction of Lower Eyelid Defects.定制化修复下眼睑缺损。
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The Utility of the Paramedian Forehead Flap in Lower Eyelid Reconstruction.旁正中前额皮瓣在下睑重建中的应用
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Medial Canthus Reconstruction with the Paramedian Forehead Flap.采用正中旁前额皮瓣进行内眦重建。
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