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Bondok MS, Bondok M, Alharbi AD, Arthurs B, El-Hadad C. Cyanoacrylate glue as a novel skin substitute in periocular skin excisions: case series and literature review. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00212-6. [PMID: 39122233 DOI: 10.1016/j.jcjo.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE Despite the widespread use of cyanoacrylate glue (CA) as an alternative for wound closure, its potential as a sole skin substitute material in periocular skin surgery remains unexplored. The primary objective was to determine the viability of CA as a sole skin substitute in periocular skin surgery after excision. DESIGN Single-centre retrospective observational case series. METHODS All patients were treated at the McGill University Health Centre from August 2023 to November 2023, where CA served as the sole skin substitute material after periocular skin excision. RESULTS Three female and one male patient, with a mean age of 75 years, received treatment with CA after skin excision for both cancerous and benign skin lesions. Specifically, histopathology revealed 2 cases of basal cell carcinoma, 1 case of squamous cell carcinoma in situ, and 2 benign lesions. The skin defects after excision ranged from 4 × 3 mm to 15 × 30 mm. No complications were observed between CA graft insertion and final skin re-epithelization. Complete re-epithelization was achieved in all patients at final follow-up without evidence of excessive skin contraction. CONCLUSIONS This study presents a novel approach by using CA as a skin substitute material in periocular skin excisions. Its liquid form allows for easy application and conforms well to irregular wound surfaces. CA may offer economic advantages, including lower material cost and shorter surgical operating times, compared with traditional skin substitutes. Further research is needed to comprehensively evaluate CA's role as a skin substitute in periocular skin reconstruction.
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Affiliation(s)
| | - Mostafa Bondok
- Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Abdulmajeed D Alharbi
- Department of Ophthalmology, College of Medicine, Qassim University, Buraydah, Saudi Arabia; Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC
| | - Bryan Arthurs
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC
| | - Christian El-Hadad
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC.
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2
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Oliver-Gutiérrez D, Oliveres J, Segura-Duch G, Arnaiz A, Ros-Sanchez E, Alonso T. Functional inferior canalicular reconstruction using a monocanalicular probe after tumor resection of the medial third of the lower eyelid. J Fr Ophtalmol 2024; 47:104236. [PMID: 38880038 DOI: 10.1016/j.jfo.2024.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To describe a surgical technique for functionally reconstructing a lacrimal drainage duct and to assess its long-term functionality. METHODS This observational review includes six cases involving reconstruction of the inferior canaliculus after surgical resection of lower eyelid carcinoma. Following lesion excision with safety margins, the epithelium of the distal portion of the inferior canaliculus is located and intubated with a monocanalicular probe. Subsequently, the eyelid lamellae are reconstructed without displacing the probe. The Monoka collarette is then sutured using a 10/0 nylon suture. Data collection included anatomic pathology of the lesion and data from ophthalmic examinations at each visit (including epiphora, inferior canalicular irrigation, and fluorescein dye disappearance test [FDDT]), as well as stent extrusion or other complications. RESULTS No complications were observed during the surgeries. The stents remained in place for an average of 4months, with no extrusions prior to removal. The mean follow-up period was 4.8years (SD=2.0), during which no other complications were noted. Only one patient experienced intermittent epiphora, also present in the fellow eye. At the final visit, FDDT was normal in all eyes, and all patients demonstrated patency of the inferior canaliculus upon irrigation. CONCLUSION Primary reconstruction of an inferior lacrimal drainage duct following tumor resection can be successfully performed, resulting in favorable functional recovery.
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Affiliation(s)
- D Oliver-Gutiérrez
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain; Innova Ocular Verte Barcelona, Vía Augusta 61, 08006 Barcelona, Spain.
| | - J Oliveres
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - G Segura-Duch
- Centro Oftalmológico Barraquer, Carrer de Muntaner 314, 08021 Barcelona, Spain; Innova Ocular Verte Barcelona, Vía Augusta 61, 08006 Barcelona, Spain
| | - A Arnaiz
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - E Ros-Sanchez
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - T Alonso
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
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3
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Hou J, Hou C, Zhang J. Combining the Tunnel Orbicularis Oculi Muscle Flap Technique With Skin Grafting for Enhanced Adhesion in Burn-Induced Ectropion Repair. Ophthalmic Plast Reconstr Surg 2024; 40:346-351. [PMID: 38738712 PMCID: PMC11090519 DOI: 10.1097/iop.0000000000002664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Scar contracture of the eyelid following facial burns often has adverse consequences. Total cicatricial contracture often makes adjustment flap translation challenging to implement. Previously used upper and lower eyelid adhesion methods are ineffective for patients with severe cicatricial contracture, and ectropion can easily recur. This study aimed to retrospectively examine upper and lower eyelid adhesions using an orbicularis oculi muscle flap and verify its stability. METHODS In patients with ectropion caused by severe scar contracture following head and face burns, we employed a tunnel orbicularis oculi muscle flap technique, which involved creating a tunnel between the skin and the tarsal plate of the eyelid, mobilizing the orbicularis oculi muscle, and rotating it into this tunnel to provide stable adhesion of the upper and lower eyelids. Full-thickness skin grafting was then performed. The eyelids were examined postoperatively to determine whether reoperation was necessary and to monitor for any potential complications. RESULTS This study included 26 patients and 46 eyes. No accidental disconnection occurred after eyelid adhesion, which lasted for an average of 21.87 ± 10.08 months before the eyelid adhesion was cut open. No complications or adverse reactions occurred, and the adhesions did not break unexpectedly. CONCLUSIONS Repairing eyelid ectropion with the tunnel orbicularis oculi muscle flap is a simple procedure that immediately creates tension against upper and lower eyelid contractures, providing long-term stable adhesion. This method avoids structural disorders, such as eyelid margin scarring, minimally influences surrounding tissues, and has few postoperative complications. It holds great value for repairing eyelid tissue defects and warrants further study.
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Affiliation(s)
- Jue Hou
- The Fourth School of Clinical Medical, Zhejiang Chinese Medical University
| | - Chunsheng Hou
- Department of Plastic and Reconstructive Surgery, Hangzhou First People’s Hospital, Hangzhou, China
| | - Jufang Zhang
- Department of Plastic and Reconstructive Surgery, Hangzhou First People’s Hospital, Hangzhou, China
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4
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Gaca PJ, Rejdak R, Lewandowicz M, Kopecky A, Kakkassery V, Heindl LM. Surgical excision of eyelid tumors and subsequent ophthalmoplastic reconstruction. DIE OPHTHALMOLOGIE 2024; 121:23-32. [PMID: 37989962 DOI: 10.1007/s00347-023-01956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/23/2023]
Abstract
In recent years new modern therapeutic concepts have been developed in the treatment of malignant eyelid tumors; however, surgical restoration remains an important component of the therapeutic options addressed, which include microsurgical tumor excision into healthy tissue and subsequent coverage of the defects. An ophthalmic surgeon experienced in oculoplastic surgery is responsible for the recognition and evaluation of the existing alterations and planning a procedure together with the patient that meets the patient's expectations. The planning of surgery must always be individualized and fit the initial findings. Depending on the defect size and localization, different coverage strategies are available to the surgeon. To ensure successful reconstruction, every surgeon should master a wide range of reconstructive techniques.
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Affiliation(s)
- P J Gaca
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland.
| | - R Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - M Lewandowicz
- Department of Oncological Surgery, Multidisciplinary M. Copernicus Voivodeship Center for Oncology and Traumatology, Lodz, Poland
| | - A Kopecky
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Ophthalmology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
- Medical Faculty, University Ostrava, Ostrava, Czech Republic
| | - V Kakkassery
- Department of Ophthalmology, University Medical Center Schleswig-Holstein, Luebeck, Germany
| | - L M Heindl
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne, Duesseldorf, Cologne, Germany
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5
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Redondo P, Barrio J, Salido-Vallejo R, Tomás-Velázquez A. Simplified lower eyelid reconstruction algorithm after basal cell carcinoma surgery: A retrospective series of patients. J Eur Acad Dermatol Venereol 2023; 37:e496-e498. [PMID: 36308054 DOI: 10.1111/jdv.18712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Pedro Redondo
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - Jesús Barrio
- Department of Ophthalmology, University Clinic of Navarra, Pamplona, Spain
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Coban I, Derin O, Sirinturk S, Pinar Y, Govsa F. Anatomical Basis for the Lower Eyelid Rejuvenation. Aesthetic Plast Surg 2023; 47:1059-1066. [PMID: 36877228 DOI: 10.1007/s00266-023-03297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/06/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND The tear trough, hollow concavity of the lower eyelid, is one of the recognizable signs of facial aging. Anatomical description is essential in improving tear through deformity for facial rejuvenation. METHODS Fifty cadaver were microdissected. Fat pad types, fat herniation and the fibrous support system of lower lid were investigated. The areas of the fat compartments were compared using photogrammetry method and ImageJ software. RESULTS Lower lids develop palpebral bags as a result of herniation of orbital fat against a weak orbital septum in all cases (%100). The attachment of the arcus marginalis at the orbital edge is a large contributor to the middle-aged appearance of the midface in all cases (100%). The most common type is Type 1 (36%). In this type, three distinct fat pads were diverged by arcuate expansion at lateral, fascia of the inferior oblique muscle at medial, as central, medial and lateral. Type 2 specimens (20%) were observed with two fat pads. Double convexity contour is in Type 3 cases (%44). It is determined that the medial fat pads are located in larger areas. Also, herniation is particularly evident in the medial and mediocentral fat pads. CONCLUSION Analysis of the lower lid morphology enables surgeons to apply safe and effective procedures. The inferior oblique muscle and arcuate expansion structures should be supported and not be damaged during surgical interventions. Surgeons should focus mainly on the anatomical data obtained, and in this sense, surgeons apply them during aesthetic and reconstructive procedures of the lower eyelids. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Istemihan Coban
- Department of Anatomy, Faculty of Medicine, Izmir Democracy University, Izmir, Turkey
| | - Okan Derin
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Suzan Sirinturk
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Yelda Pinar
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Figen Govsa
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
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7
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Gaca PJ, Rejdak R, Lewandowicz M, Kopecky A, Kakkassery V, Heindl LM. [Surgical excision of eyelid tumors and subsequent ophthalmoplastic reconstruction]. DIE OPHTHALMOLOGIE 2023; 120:252-261. [PMID: 36862183 DOI: 10.1007/s00347-023-01824-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 03/03/2023]
Abstract
In recent years new modern therapeutic concepts have been developed in the treatment of malignant eyelid tumors; however, surgical restoration remains an important component of the therapeutic options addressed, which include microsurgical tumor excision into healthy tissue and subsequent coverage of the defects. An ophthalmic surgeon experienced in oculoplastic surgery is responsible for the recognition and evaluation of the existing alterations and planning a procedure together with the patient that meets the patient's expectations. The planning of surgery must always be individualized and fit the initial findings. Depending on the defect size and localization, different coverage strategies are available to the surgeon. To ensure successful reconstruction, every surgeon should master a wide range of reconstructive techniques.
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Affiliation(s)
- P J Gaca
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
- Abteilung für Allgemeine Ophthalmologie und Pädiatrische Ophthalmologie, Medizinische Universität Lublin, Lublin, Polen.
| | - R Rejdak
- Abteilung für Allgemeine Ophthalmologie und Pädiatrische Ophthalmologie, Medizinische Universität Lublin, Lublin, Polen
| | - M Lewandowicz
- Abteilung für onkologische Chirurgie, Multidisziplinäres M. Copernicus Woiwodschaftszentrum für Onkologie und Traumatologie in Lodz, Lodz, Polen
| | - A Kopecky
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
- Klinik für Augenheilkunde, Universitätskrankenhaus Ostrava, Ostrava, Tschechien
- Medinizische Fakultät, Universität Ostrava, Ostrava, Tschechien
| | - V Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - L M Heindl
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
- Centrum für Integrierte Onkologie (CIO) Bonn-Düsseldorf-Köln, Köln, Deutschland
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8
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Duan M, Yue C, Peng J. Case report: Lower eyelid Reconstruction with the rotation flap pedicled by orbicularis oculi muscle. Front Surg 2022; 9:915124. [PMID: 36003278 PMCID: PMC9393381 DOI: 10.3389/fsurg.2022.915124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Loss of eyelid tissue can be caused by trauma, congenital defects or tumors. Eyelid reconstruction is complicated and challengingly difficult because of the complex anatomy of the eyelid. Several types of surgical procedures for the reconstruction of eyelid defects are available. Objective To describe reconstruction of lower-eyelid defects using a rotation flap pedicled by the orbicularis oculi. Methods Fourteen patients (mean age = 67 years old; ages range of 53–86 years old) who suffered from tumor excision from the lower eyelid were treated by the method. Results The mean duration of follow-up was 14 (range, 12–16) months. Ectropion, abnormal eyelid position and donor-site morbidity were not observed during follow-up. Conclusion A rotation flap pedicled by the orbicularis oculi can be a good choice for single-stage reconstruction of lower-eyelid defects.
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Affiliation(s)
- Mengying Duan
- Department of Dermatologic Surgery, Hangzhou Third People's Hospital, Hangzhou, China
| | - Chao Yue
- Department of Dermatologic Surgery, Hangzhou Third People's Hospital, Hangzhou, China
| | - Jianzhong Peng
- Department of Dermatologic Surgery, Hangzhou Third People's Hospital, Hangzhou, China
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9
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Yan Y, Fu R, Ji Q, Liu C, Yang J, Yin X, Oranges CM, Li Q, Huang RL. Surgical Strategies for Eyelid Defect Reconstruction: A Review on Principles and Techniques. Ophthalmol Ther 2022; 11:1383-1408. [PMID: 35690707 PMCID: PMC9253217 DOI: 10.1007/s40123-022-00533-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 02/08/2023] Open
Abstract
Reconstruction of eyelid defects, especially the posterior lamella, remains challenging because of its anatomical complexity, functional considerations, and aesthetic concerns. The goals of eyelid reconstruction include restoring eyelid structure and function and achieving an aesthetically acceptable appearance. An in-depth understanding of the complex eyelid anatomy and several reconstructive principles are mandatory to achieve these goals. Currently, there are multiple surgical treatment options for eyelid reconstruction, including different flaps, grafts, and combinations of them. This comprehensive review outlines the principles of reconstruction and discusses the indications, advantages, and disadvantages of currently available surgical techniques. We also propose our clinical thinking for solving specific clinical questions in eyelid reconstruction and offer perspectives on new potential methodologies in the future.
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Affiliation(s)
- Yuxin Yan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Rao Fu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Qiumei Ji
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Chuanqi Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xiya Yin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Carlo M Oranges
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Ru-Lin Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Shah S, Rakesh D, Goel S, Mittal R, Garg R, Singh K. Postavulsion complete loss of both lids with corneal injury and orbital floor fracture: A surgical challenge. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_22_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
ABSTRACT Eyelid reconstruction is a complex topic. This review looks at articles from 1990 to 2018 on eyelid reconstruction that had at least 10 patients and a mean 6 month follow-up. The authors present the results of our findings and propose an algorithm to guide the surgeon in choosing the best technique based on location, size, and lamella. Defects less than 1/3rd of the upper or lower eyelid may be closed primarily. Anterior and posterior lamella defects of the lower eyelid greater than 1/3rd in size should be reconstructed with a double mucosal and myocutaneous island flap. Those greater than 50% in size should be recreated with a Tripier flap for the anterior lamella and conchal chondroperichondral graft for the posterior lamella. For total lid reconstruction, a Fricke flap is best for the anterior lamella and the tarsoconjunctival free graft/lateral orbital rim periosteal flap is best for the posterior lamella. Full-thickness defects between 1/3rd and 2/3rd in size of the upper eyelid should be reconstructed with a myotarsocutaneous flap and those greater than 2/3rd should be reconstructed with a Cutler-Beard flap for the anterior lamella and auricular cartilage for the posterior lamella. For the medial canthal region, the island pedicle and horizontal cheek advancement flap is recommended for the anterior lamella and a composite upper lid graft for the posterior lamella. For the lateral canthal region, a bilobed flap is recommended for the anterior lamella and a periosteal flap for the posterior lamella.
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12
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Irawati Y, Paramita C, Daniel H. Challenging eyelid reconstruction in malignancies: Case reports. Ann Med Surg (Lond) 2021; 71:102987. [PMID: 34840748 PMCID: PMC8606691 DOI: 10.1016/j.amsu.2021.102987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 11/26/2022] Open
Abstract
Eye is one of the most crucial organs in need of protection. The most important function of eyelids is designed to protect the eyeball. Despite their small and thin surface area, they are among the most sunlight-exposed area of skins, hence, it is prone to develop eyelid tumors. As the malignant tumors have the tendency of growing aggressively and have a high mortality, we have to meticulously remove the lesion along with its surrounding tissue, if needed, to ensure the clearance of tumor margin. To strike a suitable outcome between the cosmetic and function after tumor removal is a quite challenging task. Compromise on aesthetics and eyelids' indispensable function of protecting the eyes during management, may lead to unfavorable cosmetic deformity and loss of vision. Therefore, it is imperative that wise selection of appropriate techniques be discussed and managed accordingly. In this article, the authors reported two case scenarios of eyelid reconstruction which was performed to show the management of full-thickness defect after removal of the malignant neoplasms. Skin flaps and graft technique used to reconstruct the eyelid in each patient was different to emphasize that eyelid malignancies require an individualized management.
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Affiliation(s)
- Yunia Irawati
- Division of Plastic and Reconstructive Surgery, Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Carennia Paramita
- Department of Ophthalmology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hisar Daniel
- Division of Plastic and Reconstructive Surgery, Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Using Buccal Mucosa and Auricular Cartilage With a Local Flap for Full-Thickness Defect of Lower Eyelid. J Craniofac Surg 2021; 32:e660-e661. [PMID: 34054082 DOI: 10.1097/scs.0000000000007770] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Reconstruction of full-thickness eyelid wounds is challenging. In this case, using buccal mucosa to repair the conjunctival surface of the lower eyelid defect maintain the function of the conjunctival surface, reduce the damage to the original ocular surface environment. Using autologous auricular cartilage as the skeleton of the eyelid defect, provided better support for the flap, and the site had a good esthetic appearance after surgery. Using skin flap to repair the skin surface of the lower eyelid defect, the eyelid defect can be repaired and good clinical results can be obtained.
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14
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Sasaki J, Matsui Y, Takatsuka S, Takenouchi T. Less extensive reconstructive surgery for full-thickness lower eyelid defect. JAAD Case Rep 2021; 13:8-10. [PMID: 34136615 PMCID: PMC8181575 DOI: 10.1016/j.jdcr.2021.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Jin Sasaki
- Division of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan.,Division of Dermatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan
| | - Yu Matsui
- Division of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan.,Department of Dermatology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Sumiko Takatsuka
- Division of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
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15
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Lee TH, Seo HJ, Park SO. Sickle-shaped transposition flap oriented along relaxed skin tension lines for lower eyelid reconstruction. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2020. [DOI: 10.14730/aaps.2020.02194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Cristofari S, Rem K, Revol M, Atlan M, Stivala A. Reconstruction of Full-Thickness Lower Lid Defects Using Texier's Procedure: Retrospective Assessment of the Indications. J Oral Maxillofac Surg 2019; 77:433-439. [DOI: 10.1016/j.joms.2018.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/25/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022]
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18
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Russo F, Linares M, Iglesias ME, Martínez-Amo JL, Cabo F, Tercedor J, Costa-Vieira R, Toledo-Pastrana T, Ródenas JM, Leis V. Reconstruction Techniques of Choice for the Facial Cosmetic Units. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:729-737. [PMID: 28666523 DOI: 10.1016/j.ad.2017.02.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A broad range of skin flaps can be used to repair facial surgical defects after the excision of a tumor. The aim of our study was to develop a practical guideline covering the most useful skin grafts for each of the distinct facial cosmetic units. MATERIAL AND METHODS This was a multicenter study in which 10 dermatologists with extensive experience in reconstructive surgery chose their preferred technique for each cosmetic unit. The choice of flaps was based on personal experience, taking into account factors such as suitability of the reconstruction technique for the specific defect, the final cosmetic result, surgical difficulty, and risk of complications. Each dermatologist proposed 2 flaps in order of preference for each cosmetic subunit. A score of 10 was given to the first flap and a score of 5 to the second. RESULTS The total score obtained for each of the options proposed by the participating dermatologists was used to draw up a list of the 3 best grafts for each site. There was notable unanimity of criteria among most of the dermatologists for reconstructive techniques such as the glabellar flap for defects of the medial canthus of the eye, the bilateral advancement flag flap or H flap for the forehead, the rotary door flap for the auricle of the ear, the Mustarde flap for the infraorbital cheek, the O-Z rotation flap for the scalp, the Tenzel flap for the lower eyelid, and the island flap for the upper lip. CONCLUSIONS The results of this study will be useful as a practical guide to choosing the best reconstruction technique for each of the facial cosmetic units.
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Affiliation(s)
- F Russo
- Servicio de Dermatología, Hospital Punta de Europa, Algeciras, Cádiz, España.
| | - M Linares
- Servicio de Dermatología, Hospital Puerta del Mar, Cádiz, España
| | - M E Iglesias
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - J L Martínez-Amo
- Servicio de Dermatología, Hospital de Poniente, El Ejido, Almería, España
| | - F Cabo
- Servicio de Dermatología, Complexo Hospitalario Universitario de Ourense, Orense, España
| | - J Tercedor
- Servicio de Dermatología, Complejo Hospitalario de Granada, Granada, España
| | - R Costa-Vieira
- Servicio de Dermatología, Centro Hospitalario e Universitário de Coimbra, Coimbra, Portugal
| | - T Toledo-Pastrana
- Servicio de Dermatología. Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - J M Ródenas
- Servicio de Dermatología, Hospital General Universitario Morales Meseguer, Murcia, España
| | - V Leis
- Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España
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19
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Huggins AB, Latting MW, Marx DP, Giacometti JN. Ocular Adnexal Reconstruction for Cutaneous Periocular Malignancies. Semin Plast Surg 2017; 31:22-30. [PMID: 28255286 DOI: 10.1055/s-0037-1598190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although the majority of lesions present in the periocular region are benign, periocular cutaneous malignancies are certainly not uncommon and must be considered. The management of nonmelanoma cutaneous malignancies is predominately surgical with Mohs micrographic surgery or excision with frozen sections. The approach to reconstruction of the resulting defects depends on the defect location and size. When able, it is preferable to close lesions directly or with the recruitment of adjacent tissue in an effort to preserve the inherent anatomy. The eyelid's dynamic function is thus maintained, which is essential for optimal ocular surface protection. However, larger and more extensive defects will require complex reconstructions that are able to restore the necessary structural integrity to the eyelids. The authors review the various reconstruction approaches for defects of all sizes involving the periocular area including nonmarginal defects and defects of the lower and upper eyelids, as well as those of the medial canthal region.
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Affiliation(s)
- Alison B Huggins
- Department of Ophthalmology, Thomas Jefferson University Hospital, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Michelle W Latting
- Department of Ophthalmology, Thomas Jefferson University Hospital, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Douglas P Marx
- Department of Ophthalmology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Joseph N Giacometti
- Oculoplastic and Orbital Surgery, Morgenstern Center for Orbital and Facial Plastic Surgery, Wayne, Pennsylvania
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20
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Hoerster R, Schlaak M, Koch KR, Ortmann M, Mauch C, Heindl LM. Merkel-Zell-Karzinom des Augenlids – eine häufig verkannte Diagnose. Ophthalmologe 2016; 114:134-139. [DOI: 10.1007/s00347-016-0355-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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