Dermolipoma surgery with rotational conjunctival flaps

Abstract

ABSTRACT.Purpose: To describe a useful technique of surgical resection of dermolipomas. Methods: This is a retrospective, noncomparative and interventional case series. Sixteen eyes of 16 patients with dermolipomas and large areas of conjunctiva strongly adherent to the masses underwent surgical removal of the dermolipomas. The anterior portion of the mass, including closely adherent conjunctiva and pilosebaceous areas, was excised, and the conjunctival defects were covered with rotational conjunctival flaps from the superior or inferior bulbar conjunctiva. Results: The mean follow-up time was 12.5 months (range, 6-47 months). The cosmetic outcome was satisfactory in all 16 patients. There were no cases of reappearance of the mass, symblepharon or significant scar formation during follow-up. One patient developed blepharoptosis and another showed limitation of medial gaze postoperatively. Both were resolved spontaneously within 3 months. There were no other significant complications. Conclusion: Rotational conjunctival flap is a useful technique of conjunctival reconstruction following removal of large dermolipomas and the overlying epithelium.

The Presentation and Surgical Treatment of Peribulbar Dermolipomas

“…Tension-free closure of the defect after excision of large dermolipomas can be difficult, and free conjunctival grafts or upper bulbar rotational flaps have been suggested for such cases; 6,7 these approaches will, however, lead to donor-site scarring which—in the upper fornix—is likely to impair upper eyelid movement and cause ptosis and might additionally interfere with future glaucoma surgery. 8 In contrast, we find that a “V-to-Y” conjunctivoplasty works well: the horizontal arm of the closure reduces symblepharon to the outer canthus (and consequent restriction of eye movements) and the remaining bulbar area is generally amenable to closure with the other 1 arms of the “Y,” and with small areas of secondary intention healing if needed.…”

“…Damage to the neighboring lacrimal gland ductules, Tenon’s sheath around lateral rectus, or upper fornix is best avoided by use of magnification during surgical microdissection. 2,3,6 Extensive resection may be required with large areas of dermis, this often limiting direct closure without tension, and several reconstructive methods have been proposed for such defects—such as conjunctival rotation flaps, autografts, or substitutes; 6,7 many of these techniques subject the neighboring normal tissues to wide mobilization and associated donor-site morbidity.…”

Early results of surgical management of conjunctival dermolipoma: partial excision and free conjunctival autograft

“…Although these reports regarding management of dermolipoma were published in the early 1990s, to date there have been very few systemic surgical outcome reports following dermolipoma surgery. Recently Sa et al 11 reported the surgical outcome of dermolipoma using rotational conjunctival flap for conjunctival reconstruction. They showed good surgical outcomes and satisfactory cosmetic results with few complications, though they did not present the details of the graft size or the conjunctival defect size.…”

Bindehautdegenerationen und -neoplasien

“…Nur der vordere Anteil der Dermolipome anterior der Orbitakante ist unter bestmöglicher Bindehautschonung zu entfernen 70 . In manchen Fällen ist eine Bindehautschwenkplastik zur Deckung des Defektes nach der Exzision erforderlich 71 . Aufgrund der Nähe zur Tränendrüse, zum M. rectus lateralis sowie dem Müller-Muskel/M.…”