Clinical observation on the repair of inferomedial eyelid defects with temporal island flaps pedicled with the orbicularis oculi muscle.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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 OF EVIDENCE

Level IV, therapeutic study.