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Reconstructions of eyelid defects.

Subramanian N - Indian J Plast Surg (2011)

Bottom Line: Many a times, the defects involve more than one area.One layer should have the vascularity to support the other layer which can be a graft.A proper plan and execution of it is very important.

View Article: PubMed Central - PubMed

Affiliation: Professor Emeritus Oculoplastic Surgery. Sankara Nethralaya; Senior Plastic Surgeon Apollo Hospital, Retired Professor and Head of the Department of Burns, Plastic and Reconstructive Surgery Kilpauk Medical college and Hospital, Chennai, India.

ABSTRACT
Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

No MeSH data available.


Related in: MedlinePlus

(a) BCC of the lateral canthal tendon. (b) Excision with the split skin graft and lateral canthal reconstruction fixation
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Figure 14: (a) BCC of the lateral canthal tendon. (b) Excision with the split skin graft and lateral canthal reconstruction fixation

Mentions: Lateral canthal defects may involve only the lateral canthus or upper or lower eyelids or both. If the defect is not involving the lid, the defect can be covered with a skin graft [Figure 14a–b]. If the lateral canthal defect extends and involves full thickness of the upper or lower eyelids, reconstruction can be done by transposing a conjunctival flap from the same lid with the skin graft. For larger defects, a transposition flap from the forehead or an island flap based on the anterior branch of the superficial temporal artery for anterior lamella and mucus membrane graft for lining would be the alternate method. Lateral canthus can be reconstructed by using a periosteal flap from the lateral wall of the orbit and anchored to the remnant of the tarsal plate of the eyelid. A fascial graft from temporalis fascia or palmaris longus tendon can be used. This fascial graft would have to be anchored to the lateral wall of the orbit via drill holes made in the bone. Medially, it has to be anchored to the MCT. The fixation of the lateral tendon should be 3 mm above the level of medial canthus.


Reconstructions of eyelid defects.

Subramanian N - Indian J Plast Surg (2011)

(a) BCC of the lateral canthal tendon. (b) Excision with the split skin graft and lateral canthal reconstruction fixation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111123&req=5

Figure 14: (a) BCC of the lateral canthal tendon. (b) Excision with the split skin graft and lateral canthal reconstruction fixation
Mentions: Lateral canthal defects may involve only the lateral canthus or upper or lower eyelids or both. If the defect is not involving the lid, the defect can be covered with a skin graft [Figure 14a–b]. If the lateral canthal defect extends and involves full thickness of the upper or lower eyelids, reconstruction can be done by transposing a conjunctival flap from the same lid with the skin graft. For larger defects, a transposition flap from the forehead or an island flap based on the anterior branch of the superficial temporal artery for anterior lamella and mucus membrane graft for lining would be the alternate method. Lateral canthus can be reconstructed by using a periosteal flap from the lateral wall of the orbit and anchored to the remnant of the tarsal plate of the eyelid. A fascial graft from temporalis fascia or palmaris longus tendon can be used. This fascial graft would have to be anchored to the lateral wall of the orbit via drill holes made in the bone. Medially, it has to be anchored to the MCT. The fixation of the lateral tendon should be 3 mm above the level of medial canthus.

Bottom Line: Many a times, the defects involve more than one area.One layer should have the vascularity to support the other layer which can be a graft.A proper plan and execution of it is very important.

View Article: PubMed Central - PubMed

Affiliation: Professor Emeritus Oculoplastic Surgery. Sankara Nethralaya; Senior Plastic Surgeon Apollo Hospital, Retired Professor and Head of the Department of Burns, Plastic and Reconstructive Surgery Kilpauk Medical college and Hospital, Chennai, India.

ABSTRACT
Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

No MeSH data available.


Related in: MedlinePlus