背景:肿瘤切除后的下眼睑组织次全丢失对于重建外科医生来说是一个复杂的问题。必须修复前后皮瓣,以避免损害眼睛的功能和美学预后。这项研究将中隔软骨粘膜移植物用于后片,并在颞动脉上蒂用于前片。
方法:我们进行了为期10年的单中心回顾性研究,包括18例患者,他们在肿瘤切除后使用颞动脉蒂皮瓣进行了中隔软骨粘膜移植物治疗。我们收集了与皮瓣存活相关的人口统计学和医学外科数据,没有外翻,眼球和其他术后并发症。在最后一次随访咨询中,使用分级量表判断美学结果。
结果:所有移植物和皮瓣均存活,而2例患者需要早期重复手术(1例用于外翻,1例用于移植部位血肿)。所有患者均未出现红眼。两名患者的远端皮瓣损伤通过局部护理治愈。所有患者在最后一次随访时对美学结果感到满意。
结论:将中隔软骨粘膜移植物与颞动脉蒂筋膜皮瓣联合进行下睑全貌重建是一种可靠的方法,具有令人满意的功能和美容效果。
BACKGROUND: Subtotal and total lower eyelid tissue loss after tumour excision is a complex issue for reconstructive surgeons. The anterior and posterior flaps must be restored to avoid compromising the functional and aesthetic prognosis of the eye. This study used a septal chondromucosal graft for the posterior lamella and a fasciocutaneous flap pedicled on the temporal artery for the anterior lamella.
METHODS: We conducted a 10-year monocentric retrospective study, including 18 patients who were treated using a septal chondromucosal graft with a temporal artery pedicle flap following tumour excision. We collected demographic and medico-surgical data related to flap survival, absence of ectropion, lagophthalmos and other post-operative complications. The aesthetic outcome was judged using a grading scale during the last follow-up consultation.
RESULTS: All grafts and flaps survived, whereas 2 patients required early repeat surgery (1 for ectropion and 1 for graft site haematoma). None of the patients developed lagophthalmos. Two patients had distal flap injuries that healed with local care. All patients were satisfied with the aesthetic outcome at the last follow-up visit.
CONCLUSIONS: Combining a septal chondromucosal graft with a fasciocutaneous flap pedicled to the temporal artery for total lower eyelid reconstruction is a reliable method with satisfactory functional and cosmetic outcomes.