Liu Fang, Zhang Lin, Zhao Yu
Department of Plastic Surgery, The First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei City, Anhui Province, China.
Int Ophthalmol. 2025 Jun 12;45(1):241. doi: 10.1007/s10792-025-03614-2.
The repair of Lower eyelid defect is a medical challenge for plastic surgeons. Objective to investigate the clinical effect of repairing inferomedial eyelid defects with temporal island flaps pedicled with the orbicularis oculi muscle.
A retrospective analysis was conducted on 12 cases of inferomedial eyelid defects caused by tumors, scars or other reasons, in The First Affiliated Hospital of Anhui Medical University from January 2021 to October 2022. Temporal island flaps pedicled with the orbicularis oculi muscle or traditional nasolabial fold flaps were used to repair the inferomedial eyelid defects, and the patients were followed up for 2 to 13 months to observe postoperative tumor residue, scar release degree, flap survival, lower eyelid ectropion. Descriptive statistical methods were used to evaluate the treatment effect.
In 11 out of 12 patients, the tumors were completely resected with no residual at the margins and bases. In 1 patient with lower eyelid ectropion, it was completely corrected, which the scar was completely released and the lower eyelid was restored. The flaps in all 12 patients survived completely, and in one case, there was partial epidermal necrosis, which healed after dressing change and delayed healing. One patient designed the nasolabial V-Y advancement flap developed eyelid ectropion and retraction. During the follow-up period of 2 to 13 months, no lower eyelid ectropion or epiphora occurred.
The orbicularis oculi muscle-pedicled temporal island flap demonstrates significant clinical efficacy in reconstructing inferomedial eyelid defects, particularly due to its combination of surgical practicality and favorable tissue characteristics. This technique offers three distinct advantages: (1) straightforward surgical preparation with minimal donor site morbidity, (2) optimal tissue compatibility through preserved eyelid texture and robust vascular supply, and (3) enhanced rotational capacity and generous flap dimensions.
Level IV, therapeutic study.
下睑缺损修复是整形外科医生面临的一项医学挑战。目的探讨以眼轮匝肌为蒂的颞部岛状皮瓣修复下睑内眦部缺损的临床效果。
回顾性分析2021年1月至2022年10月安徽医科大学第一附属医院收治的12例因肿瘤、瘢痕等原因导致的下睑内眦部缺损患者。采用以眼轮匝肌为蒂的颞部岛状皮瓣或传统鼻唇沟皮瓣修复下睑内眦部缺损，对患者进行2至13个月的随访，观察术后肿瘤残留、瘢痕松解程度、皮瓣存活情况、下睑外翻等情况。采用描述性统计方法评估治疗效果。
12例患者中11例肿瘤完全切除，切缘及基底无残留。1例下睑外翻患者完全矫正，瘢痕完全松解，下睑恢复正常。12例患者皮瓣均完全存活，1例出现部分表皮坏死，经换药及延期愈合后痊愈。1例设计鼻唇沟V-Y推进皮瓣患者出现眼睑外翻及退缩。随访2至13个月期间，未出现下睑外翻或溢泪。
以眼轮匝肌为蒂的颞部岛状皮瓣在修复下睑内眦部缺损方面显示出显著的临床疗效，特别是因其手术操作简便且供区损伤小、保留眼睑质地且血供丰富具有最佳的组织相容性、旋转能力强且皮瓣面积大等优点。
四级，治疗性研究。
