睑板腺癌术后眼睑缺损的整复

Eyelid reconstruction after resection of meibomian gland carcinoma

目的探讨睑板腺癌术后眼睑缺损的整复方法。方法睑板腺癌6例。1例上睑肿物切除后上睑缺损小于1/4,创缘直接分层缝合;1例上睑肿物切除后上睑缺损大于1/2,但未侵及睑板上缘,残留睑板结膜瓣向下滑行修复缺损;2例肿物侵及睑板上缘,切除后缺损分别大于1/2和3/4,下睑板结膜滑行修复上睑缘,上睑提肌瓣向下滑行和滑行睑板吻合;1例下睑肿物切除后缺损大于3/4,鼻颊部皮瓣转移修复;1例部分眶内容摘除植皮修复。结果术后随访观察12～19个月,1例眶内容摘除眶内皮片成活良好,其余5例眼睑外形及功能均恢复,眼睑闭合好,活动自如。结论睑板腺癌切除术后根据眼睑缺损的部位和大小选择不同的修复方案,均取得了良好的效果。

Objective To investigate the reduction of blepharocoloboma postoperative carcinoma of meribomian glands. Methods Taking different types in 6 cases. Suturing wound edge directly in 1 case whose upper eyelid defect less than 1/4 after tumor resection. 1 case was reducted by remainde tarsal-conjunctival advancement flapwhose defect more than 1/2 without invading superior margin of tarsus. 2 other upper lids defects, more than 1/2 and 3/4 with invading superior margin of tarsus, was repaired by the transpositional tarsoconjunctival flap from lower to upper eyelid and then anastomosed with advancement levator muscle flap of upper eyelid. 1 case whose defect more than 3/4 was repaired by nasal medial transposition flap. 1 orbital exenteration was repaired by re- planting free skin graft. Results All caseswere followed up for 12 to 19 months,and in 1 case free skin graft was good to survive,and another 5 cases also show good effects including outline form, function, catacleisis and activity. Conclusion Taking different projects on the basis of the area and range of eyelid defect postoperative carcinoma of meibomian glands are satisfactory.