Abstract:
Reconstructive surgery of the eyelid after tumor excision, trauma or other causes can be challenging, especially due to the complexities of the anatomic structures and to the necessity of both functional and aesthetic successful outcomes. The aim of this minireview was to investigate the use of tissue transplantation in eyelid reconstruction. Surgical procedures are various, based on the use of both flaps, pedicled or free, and grafts, in order to guarantee adequate tissue reconstruction and blood supply, which are necessary for correct healing. Common techniques normally include the use of local tissues, combining non-vascularized grafts with a vascularized flap for the two lamellae repair, to attempt a reconstruction similar to the original anatomy. When defects are too wide, vast, deep, and complex or when no adjacent healthy tissues are available, distant area tissues need to be recruited as free flaps or grafts and paired with mucosal layer reconstruction. With regards to the anterior lamella, full thickness skin grafts are commonly preferred. With regards to the reconstruction of posterior lamella, there are different graft options, which include conjunctival or tarsoconjunctival, mucosal or palatal or cartilaginous grafts usually combined with local flaps. Free flap transplantation, normally reserved for rare select cases, include the use of the radial forearm and anterolateral flaps combined with mucosal grafts, which are surgical options currently reported in the literature.
摘要:
肿瘤切除后眼睑的重建手术,创伤或其他原因可能具有挑战性,特别是由于解剖结构的复杂性以及功能和美学成功结果的必要性。本综述的目的是研究组织移植在眼睑重建中的应用。外科手术多种多样,基于两个襟翼的使用,带蒂的或游离的,和移植物,为了保证足够的组织重建和血液供应,这是正确治疗所必需的。常见的技术通常包括使用局部组织,将非血管化移植物与血管化皮瓣相结合,用于修复两个薄片,尝试类似于原始解剖结构的重建。当缺陷太宽时,广阔,深,复杂或没有相邻的健康组织时,远端区域组织需要作为游离皮瓣或移植物募集,并与粘膜层重建配对。关于前片,全厚度皮肤移植物通常是首选。关于后板的重建,有不同的移植选择,包括结膜或骨结膜,粘膜或腭或软骨移植物通常与局部皮瓣结合。游离皮瓣移植,通常保留用于罕见的精选病例,包括使用前臂和前外侧皮瓣结合粘膜移植物,这是目前文献报道的手术选择。