Reconstruction of the Lower Eye Lid With a Rotation-Advancement Tarsoconjunctival Cheek Flap

To describe a modified surgical procedure that uses a combination of the tarsoconjunctival flap, orbicularis myocutaneous advancement flap, and paranasal-island flap to correct extensive full-thickness lower eyelid defects in functioning eyes.From May 2010 to December 2013, a total of 15 patients had reconstructive surgeries of large to giant lower eyelid defect, with an average 19-month follow-up. The musculocutaneous flaps were harvested from both orbicularis and paranasal regions and clinical outcomes were recorded and analyzed.No major complications were observed in any of the patients. All the patients showed aesthetic eyelid contour, good color, and texture match as well as no obvious scar formation. The mean Marginal Reflex Distance-2 measured 4 months after surgery was 4.9 ± 0.4 mm.Reconstruction of a large defect in the lower eyelid with a tarsoconjunctival flap and the composite neighboring musculocutaneous flaps is a reliable and reproducible method. With proper design and well-executed precision, excellent functional and aesthetic results can be achieved by this elegant procedure without any major complications.

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“…However, drawbacks including retraction, extensive tissue dissection, and facial nerve damage have been reported. 23 – 25 …”

Section: Discussionmentioning

confidence: 99%

The Use of Composite Flaps in the Management of Large Full-Thickness Defects of the Lower Eyelid

Fang

Yang

Zhang³

et al. 2016

Medicine

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“…In the literature, a number of procedures for lower lid reconstructions are reported [1,3,4,5,6,7,8,9,10,11,12,13]. We used a semicircular flap or simple lateral advancement flap in 31 cases, and we obtained total success in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…The availability of surrounding tissues is scarce for upper lid reconstructions; therefore, reconstructions of the upper lid are rarely reported in the literature and they may sometimes require technically demanding flaps [1,2]. Conversely, a number of techniques have been described to reconstruct defects involving the lower lid [3,4,5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

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Partial and Total Lower Lid Reconstruction: Our Experience with 41 Cases

Fogagnolo

Colletti²,

Valassina³

et al. 2012

Ophthalmologica

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Purpose: To report our experience on lid reconstruction in patients with epitheliomas. Methods: A total of 41 consecutive patients affected by basal cell (n = 32) or squamous cell carcinoma (n = 9) underwent partial (n = 35) or total (n = 6) surgical demolition of the lower lid. Surgical defects <25% (n = 10) received direct closure. If the defect involved 30–60% of the eyelid (n = 21), a Tenzel semicircular flap or lateral advancement flap with a free mucosal graft was used. If the entire lid or a major part of the outer lamella had to be reconstructed (n = 10), a cheek advancement flap was used, with a free mucosal graft if the posterior lamella was involved. The success rates and the cosmetic and functional results were evaluated. Results: All 21 flaps used for partial reconstruction remained viable, whereas 1 of the 10 cheek flaps developed partial distal necrosis. Of the 27 mucosal grafts, 2 had to be removed for total necrosis, and 2 developed partial necrosis. In all cases, normal lid function and acceptable cosmetic results were obtained. Complications occurring in 4 cases (1 ectropion and 3 epiphora) were successfully managed with appropriate surgical procedures. Conclusions: Local flaps are the gold standard for lower lid reconstruction as they are highly reliable and guarantee optimal results. The technical details described in this study can help in achieving such results.

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“…Because the eyelid is a layered structure, appropriate layered reconstruction is essential, with the goal towards restoring periocular function and minimizing any postsurgical complications [4, 12]. Proper eyelid volume and shape should be strived for [4, 13]. …”

Section: Introductionmentioning

confidence: 99%

Principles of Periocular Reconstruction following Excision of Cutaneous Malignancy

Hayano

Whipple

Korn

et al. 2012

Journal of Skin Cancer

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Reconstruction of periocular defects following excision of cutaneous malignancy can present difficulties for oculofacial and reconstructive surgeons. The intricate anatomy of the eyelids and face requires precise restoration in order to avoid postoperative functional anesthetic concerns. Various reconstructive procedures based on common principles, location and size of the defect, can be applied to achieve restoration with the best possible functional and aesthetic outcomes.

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Reconstruction of the Lower Eye Lid With a Rotation-Advancement Tarsoconjunctival Cheek Flap

Cited by 15 publications

References 16 publications

The Use of Composite Flaps in the Management of Large Full-Thickness Defects of the Lower Eyelid

The Use of Composite Flaps in the Management of Large Full-Thickness Defects of the Lower Eyelid

Partial and Total Lower Lid Reconstruction: Our Experience with 41 Cases

Principles of Periocular Reconstruction following Excision of Cutaneous Malignancy

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