Total Lower Eyelid Reconstruction Using Paranasal Flap

Abstract

The main aim of this study is to evaluate the advantages, disadvantages, and aesthetic results of the total lower eyelid reconstruction with paranasal flap. The other reconstruction methods are also revisited.Ten patients, who were operated for the reconstruction of total lower eyelid defects between November, 1999 and April, 2005 in our department were included in this study. The total lower eyelid defects of all patients were reconstructed using paranasal flap for anterior lamella and chondromucosal, chondrocutaneous or mucosal graft for posterior lamella. Follow-up time was ranged between 3-35 months. The advantages, disadvantages and complications were defined and aesthetic results of the patients were also evaluated by using a questionnaire which was filled by patients at third month after reconstruction. All flaps and grafts survived, partial or total necrosis was not encountered but one patient with ectropion had a secondary reconstructive procedure. The aesthetic results of the patients were also satisfactory. The paranasal flap is very reliable and safe method for total lower eyelid reconstruction.

Superiorly based nasolabial island flap for reconstruction of the lateral lower eyelid

“…Along with the use of the nasolabial island flap as in the presented technique, nasolabial transposition flaps (16)(17)(18) can be used effectively for the repair of lower eyelid defects. However, the skin incisions of the transposition flaps should be performed more superiorly than the nasolabial island flap, which results in a more extensive donor site scar.…”

“…However, wide dissection is required for adequate mobilization of the flap, and the surgical procedure is mostly performed under general anesthesia. In addition, ectropion due to gravity or contraction of the scar is one of the main disadvantages of the Mustardé flap (17).…”

“…It is a random-pattern cutaneous flap with redundant blood supply from the perforating branches of the facial and angular arteries and can be used as an inferiorly or superiorly based flap (11,12). It has a wide spectrum of use for nasal and midfacial defects (13,14) and can be used as an island (15) or transposition flap (16)(17)(18) for the reconstruction of the lower eyelid.…”

Reconstruction of Lower Eyelid Retraction or Ectropion Using a Paranasal Flap

“…The paranasal or nasolabial flap with its modification for reconstruction of total lower eyelid defects after resection of tumors also has achieved satisfactory results [9,10]. Each flap has its advantages and disadvantages, and the surgeon has to decide and justify his flap selection.…”

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

“…This is reflected in the numerous methods of reconstruction that have been described (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11), none with universal acceptance. The main aim of lower eyelid reconstruction is to produce a functional and aesthetically pleasing lower eyelid with minimum morbidity.…”