Upper and Lower Eyelid Reconstruction

Codner, Mark A.; McCord, Clinton D.; Mejia, Juan Diego; Lalonde, Donald H.

doi:10.1097/prs.0b013e3181eff70e

Cited by 47 publications

(49 citation statements)

References 18 publications

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“…La obtención de un resultado funcional y estético debe iniciarse con un análisis de la complejidad del defecto y con la valoración por separado de sus componentes. El disponer de un algoritmo de abordaje de la lesión, junto con una técnica quirúrgica meticulosa, permitirá obtener resultados ópti-mos y evitar futuras complicaciones (6).…”

Section: Discussionunclassified

Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

García‐García¹,

Cárdenas-Mejía²

2014

Cir. plást. iberolatinoam.

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ResumenEl párpado es una estructura crítica para la protección y función del globo ocular, y parte primordial en la esté-tica facial. Su reconstrucción está determinada por la extensión de la lesión y el compromiso de las diferentes capas. Siempre se preferirán tejidos loco-regionales debido a su mayor similitud y disposición. Los métodos de reanimación palpebral se pueden dividir en estáticos y dinámicos, considerando a estos últimos como el único medio para restaurar el parpadeo.Presentamos un caso de celulitis orbitaria preseptal con lesión de espesor total del párpado superior y su reconstrucción miofuncional utilizando un colgajo frontal. Este colgajo frontal miocutáneo logró la restauración funcional del párpado comprometido mediante la adición de fibras musculares y permitiendo el fenómeno de reinervación. Palabras clave Celulitis orbitaria,Colgajo pediculado, Terapias miofuncionales. Nivel de evidencia científica V AbstractThe eyelid is a critical and protective structure for the eyeball, and a principal part for the facial aesthetic. The extension of the injury and the affected layers determine the kind of reconstruction. It´s always preferred a loco-regional tissues because their similitude and availability. The reanimation methods can be separated in statics and dynamics, always considering the last mentioned like the unique option for blink restoration.We present a case report of orbital preseptal cellulitis with upper eyelid total thickness injury and the reconstruction with a myofunctional forehead flap. This flap allowed the functional eyelid reestablishment by using the muscle fibers and the reinervation phenomenon.

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Section: Discussionunclassified

Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

García‐García¹,

Cárdenas-Mejía²

2014

Cir. plást. iberolatinoam.

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“…Moreover, each of these structures requires separate approaches for proper function. The principles of when to use a graft, direct closure, lid-sharing procedures or distant flap have been described in many review articles and textbooks (17)(18)(19)(20)(21)(22)(23)(24). These principles include restoring coverage, support and lining, maintaining mobility of the upper eyelid (opening and closing) and position and stability of the lower eyelid.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, several articles describe reconstruction options for either upper or lower eyelids, while very few focus on defects that span both upper and lower eyelids (17,25).…”

Section: Discussionmentioning

confidence: 99%

The Temporalis Muscle Flap: A Useful Adjunct in Reconstruction of Combined Defects of the Upper and Lower Eyelids

Haykal

Antonyshyn

Gill

2015

Plastic Surgery Case Studies

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R econstruction of complex eyelid defects presents a challenge. Composite defects that involve both the upper and the lower eyelid, or that extend deeply to involve the lateral canthus and the bony orbit, are particularly difficult to repair. Under these circumstances, the temporalis muscle flap provides vascularized tissue, which can be used in restoring structural support to the lid complex.The temporalis region provides several regional flaps. The temporalis muscle is a type III (Mathes and Nahai classification) fan-shaped muscle with its origin in the temporal fossa. It receives its blood supply from the anterior and posterior deep temporal arteries, which are branches of the internal maxillary artery. These course between the muscle and the periosteum, allowing for subperiosteal elevation. Resection of the zygomatic arch and the coronoid process of the mandible (1) can increase its reach. The presence of two independent vascular territories enables separate use of the temporalis fascia or muscle in the elevation of regional flaps, making it very versatile in head and neck reconstruction (1). It has been described for isolated upper eyelid defects (2-4) and orbital reconstruction (5-12). BACKGrounD: Eyelid reconstruction following oncological resection remains a challenge. Multiple techniques have been described for isolated upper or lower eyelid defects. oBJECTIvE: To describe the use of the temporalis flap for reconstruction of an eyelid defect involving both the upper and lower eyelids. METHoDs: Excision of a basal cell carcinoma was performed. This resulted in full-thickness defects of the upper and lower eyelids, the lateral canthus including upper and lower canthal tendons, the upper right midface, temple, lateral two-thirds of the eyebrow and forehead. The tumour was found to be adherent to bone and dissecting deeply into the lateral orbital cavity as well as along the orbital roof. rEsuLTs: The lateral orbital rim was reconstructed using the pre-bent titanium mesh implant. A temporalis muscle flap allowed for draping over the reconstructed orbital rim and to provide reconstruction of the tarsal plates of the upper and lower eyelids. The remaining large cutaneous defect, which involved more than half of the lower eyelid, was reconstructed using a large Mustarde cervical facial rotation flap. ConCLusIons: The temporalis muscle flap provides abundant well vascularized tissue and has been described for head and neck reconstruction. A novel technique allows reconstruction of both the upper and lower eyelids using the temporalis muscle in combination with local flaps.

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“…The eyelids are important components of physical beauty. Hence, proper reconstruction of the eyelids is an important challenge after tumor surgery (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

“…The patient's requirements must also be taken into account during the formulation of surgical modality. The close proximity of the lacrimal system to the medial canthal region must be remembered for proper diagnosis and treatment (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Surgical Reconstruction of the Eyelids after Tumor Excision: Our Experience with 147 Cases

Nuhoglu¹,

Ozdemir²,

Abul³

et al. 2015

JAREM

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Objective: To evaluate the outcomes of various methods for surgical reconstruction of upper and lower eyelids after tumor excision.Methods: Data from 147 cases that were operated on due to tumors of the upper or lower eyelids between 2007 and 2011 were retrospectively analyzed. Surgical success was described as defect closure, proper valve function, appropriate lid contour, and good cosmetic appearance. Postoperative follow-up was performed on the 1st day and 1st week and every month afterwards. Results:The mean duration of follow-up was 8.9 months (6-36 months). Types of surgical interventions consisted of elliptical excision, sutureless excision, rotational flap, advancement flap, Tenzel flap, and blepharoplasty. Scarring at the medial canthus, lid contour deformity, and trichiasis were the complications encountered in the postoperative period. Winking reflex was preserved, and complete closure of eyelids was provided in all of the patients. The overall rate of surgical success was found to be 94.6%. Conclusion:Reconstruction of eyelids is an important issue after the complete excision of a tumor and achievement of tumor-free margins. The reconstructive technique must be appropriate for the location and the size of the lesion, aiming to provide a proper shape and contour for the eyelids. (JAREM 2014; 4: 97-101) Key Words: Flap, graft, eyelid, tumor, surgery, reconstruction ÖZET Amaç: Alt ve üst göz kapağın malign tümöral kitlelerinİn ekzisyonu uygulandıktan sonra oluşan göz kapağı defektlerinde uygulanan rekonstrüksiyon teknikleri ve klinik sonuçlarını değerlendirmek amaçlandı.Yöntemler: 2007 ve 2011 yılları arasında üst veya alt göz kapaklarında tümöral kitle nedeniyle eksizyon yapılan 147 olgunun verileri retrospektif olarak analiz edildi. Cerrahi başarı defektlerin tamamen kapanması, düzgün kapak fonksiyonu, uygun kapak kontur ve iyi kozmetik görünüm sağlanması olarak değerlendirildi. Ameliyat sonrası takip 1. gün, 1. hafta ve sonrasında aylık olarak yapıldı. Bulgular: Takip süresi ortalama 8,9 ay (6-36 ay) idi. Kullanılan cerrahi rekonstruksiyon teknikleri eliptik eksizyon, sütürsüz eksizyon, rotasyonel flep, ilerletme flebi, Tenzel flep ve blefaroplasti idi. Medial kantusta yara izi, kapak kontur deformitesi ve trikiyazis postoperatif dönemde karşılaşılan komplikasyonlardı. Göz kırpma refleksi tüm olgularda korundu .Göz kapaklarının tam kapanması bütün olgularda sağlandı. Cerrahi başarı oranı % 94,6 idi.Sonuç: Göz kapaklarının tümöral kitlelerinin tam eksizyonu sonrası düzgün kapak kontur ve pozisyonunun sağlanması önemlidir. Rekonstrüksiyon teknikleri göz kapakları için uygun bir şekil ve kontur sağlamayı amaçlamalı, lezyonun yerleşimine ve büyüklüğüne uygun olmalıdır. (JAREM 2014; 4: 97-101)

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Upper and Lower Eyelid Reconstruction

Cited by 47 publications

References 18 publications

Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

The Temporalis Muscle Flap: A Useful Adjunct in Reconstruction of Combined Defects of the Upper and Lower Eyelids

Surgical Reconstruction of the Eyelids after Tumor Excision: Our Experience with 147 Cases

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