耳甲腔复合组织联合面部皮瓣修复眼睑全层缺损的应用

Application of cavum conchae composite tissue combined with facial skin flap in the repair of eyelid full-thickness defect

目的探讨耳甲腔皮肤、软骨复合组织联合面部皮瓣修复大于2/3眼睑长度全层缺损的手术方法及术后效果。方法选取切除眼睑肿瘤后睑板、睑结膜缺损横径均超过2/3眼内外眦间距的患者,根据睑结膜、睑板的缺损面积,切取相应大小的耳甲腔皮肤、软骨复合组织,替代修复结膜、睑板,根据面部皮肤缺损大小设计合适的面部皮瓣,并覆盖软骨外侧面。结果本组共16例患者采用上述方法修复全层眼睑缺损,未发生移植物、皮瓣坏死,术区瘢痕轻微,眼睑开闭功能良好,耳部供区无畸形。结论耳甲腔复合组织联合面部皮瓣修复眼睑全层缺损,可达到较理想的外观和功能恢复。

Objective To explore the surgical method and postoperative efficacy of cavum conchae skin and cartilage composite tissue combined with facial skin flap in the repair of full-thickness defects of eyelid length greater than 2/3.Methods Patients with a tarsal plate after eyelid tumor resection with a transverse palpebral conjunctival defect diameter greater than 2/3 length between the inner and outer canthus were selected.Depending on the defect area of the palpebral conjunctiva and tarsal plate,the corresponding size of cavum conchae skin and cartilage composite tissue was cut to replace and repair the defects of the palpebral conjunctiva and tarsal plate.An appropriate facial flap was designed to cover the lateral surface of the transplanted cartilage,according to the size of the facial skin defect.Results The above method was adopted in 16 cases to repair full thickness of the eyelid.No graft,skin flap necrosis,or auricular donor site deformity occurred.The scar was slight and the opening and closing function of the eyelid was good.Conclusion The application of cavum conchae composite tissue combined with facial skin flap in the repair of eyelid full-thickness defects can achieve a relatively ideal appearance and recovery of function.