目的:回顾内侧(经鼻或经睑)半规形皮瓣重建内侧can的结果。
方法:回顾了38例接受上述手术的患者的病历。肿瘤切除后,沿鼻梁或眉间形成的半圆形皮瓣前进到can缺损;如有必要,该皮瓣与其他重建方法相结合。
结果:患者(19名男性,19名女性;平均年龄,66年)患有基底细胞癌(n=36)或鳞状细胞癌(n=2)。平均肿瘤直径为9.2mm(范围,3-21毫米)。21例患者(55%)的肿瘤中心位于can中区域,17例患者(45%)的肿瘤中心位于下或上区域。切除后,22例患者只有鼻甲缺损,和16有相关的上眼睑和/或下眼睑缺损。为了弥补缺陷,19例患者(50%)仅使用内侧半圆形皮瓣,19例患者(50%)与其他皮瓣联合使用。切除缺损主要在37例患者(97%)中闭合。未发生皮瓣坏死或感染。在随访期间(范围,1-91个月;中位数,19个月),10例(26%)患者共发生17种并发症。三名患者(8%)因眼睑重建相关并发症需要二次手术。
结论:经鼻或经睑半规形皮瓣可能是内than重建的良好选择。对于大型或复杂的缺陷,内侧半圆形皮瓣可与其他眼周皮瓣联合使用。在后一种情况下,需要二次手术的术后并发症可能发生.
OBJECTIVE: To review the results of medial canthal reconstruction with the medial (transnasal or transglabellar) semicircular flap.
METHODS: Medical charts of 38 patients who underwent the described procedure were reviewed. After tumor excision, a semicircular flap created along the nasal bridge or glabella was advanced to the canthal defect; if necessary, this flap was combined with other reconstructive methods.
RESULTS: The patients (19 male, 19 female; mean age, 66 years) had basal cell (n = 36) or squamous cell (n = 2) carcinomas. The mean tumor diameter was 9.2 mm (range, 3-21 mm). Tumor epicenters were in the midcanthal area in 21 patients (55%) and in the infra- or supracanthal areas in 17 patients (45%). After excision, 22 patients had only canthal defects, and 16 had an associated upper and/or lower eyelid defect. To cover the defect, the medial semicircular flap alone was used in 19 patients (50%) and in association with other flaps in 19 patients (50%). The excisional defect was primarily closed in 37 patients (97%). Flap necrosis or infection did not occur. During follow-up (range, 1-91 months; median, 19 months), 10 patients (26%) developed a total of 17 complications. Three patients (8%) required secondary surgery for eyelid reconstruction-related complications.
CONCLUSIONS: Transnasal or transglabellar semicircular flap may be a good alternative for medial canthal reconstruction. For large or complex defects, the medial semicircular flap can be combined with other periocular flaps. In the latter case, postoperative complications requiring secondary surgery may develop.