硬腭黏膜联合鼻唇沟皮瓣修复大面积下睑全层缺损

Application of Hard Palate Mucosa Combined Nasolabial Flap in Repairing Large Area Inferior Eyelid Full-thickness Defect

目的:探讨应用硬腭黏膜联合鼻唇沟皮瓣修复大面积下睑全层缺损的手术方法及疗效。方法:2014年9月-2016年4月收治下睑全层缺损患者10例,均采用硬腭黏膜联合带穿支血管的鼻唇沟皮瓣修复下睑全层缺损。结果:10例患者皮瓣及硬腭黏膜全部成活,术后24h内有2例患者皮瓣远端出现静脉回流障碍,给予促血液循环等对症治疗后缓解。8例患者随访6～24个月,平均13个月。皮瓣质地柔软、色泽正常。供区瘢痕不明显,患者均无眼部不适症状,对手术效果满意。结论:硬腭黏膜联合鼻唇沟皮瓣具有血供丰富、成活率高,术后无明显瘢痕及眼睑继发畸形,皮瓣色泽与周围皮肤一致,效果满意等优点,是一种修复下睑全层缺损的较好方法。

Objective To investigate the surgical method and effectiveness of hard palate mucosa combined nasolabial flap in repairing large area inferior eyelid full-thickness defect. Methods 10 patients with lower eyelid full-thickness defect were treated in our hospital from September 2014 to April 2016. All patients were treated with hard palate mucosa combined with nasolabial groove skin flaps with perforating vessels to repair lower eyelid full-thickness defect. Results The flaps all survived in 10 patients, 2 patients had venous obstruction at the distal end of the flap within 24h after operation, and 8 patients were followed up for 6 to 24 months. The average is 13 months. The skin flap is soft in texture and normal in color. Scar in donor area was not obvious. All patients had no symptoms of ocular discomfort. The patient was satisfied with the effect of the operation. Conclusion The hard palate mucous combined with nasolabial flap has abundant blood supply, high survival rate, no obvious scar and secondary deformity of eyelid after operation, the color of the flap is consistent with that of the surrounding skin, and the effect is satisfactory. It is a better method to repair the lower eyelid defect.