异体巩膜移植与自体唇黏膜以及邻近皮瓣转移修复眼睑肿瘤切除后眼睑缺损的美容效果对比

Comparison of cosmetic effects between allogeneic scleral transplantation and autologous lip mucosa and adjacent flap transfer for repairing orbital defect after orbital tumor resection

目的探讨异体巩膜移植与自体唇黏膜以及邻近皮瓣转移修复眼睑肿瘤切除后眼睑缺损的美容效果。方法选取2017年11月至2019年3月间收治眼睑肿瘤切除后眼睑缺损患者21例(21眼)进行研究,根据修复方法不同分组,A组11例(11眼)采用异体巩膜移植,B组10例(10眼)采用自体唇黏膜以及邻近皮瓣转移修复,对两组修复效果及美容评分、并发症发生率进行观察。结果两组修复前的睑裂长度、睑裂高度差值无明显差异(P> 0.05),A组修复后的睑裂长度、睑裂高度差值与B组比较有明显差异(P <0.05);修复前,两组美容评分无明显差异(P> 0.05),A组修复后的美容评分明显较B组高(P <0.05);A组修复后感染、上睑下垂、缝线崩脱、睑缘切痕等并发症发生率明显较B组低(P <0.05)。结论修复眼睑肿瘤切除后缺损应用异体巩膜移植的效果更好,可促进眼睑形态恢复,也能提高美容效果,值得推广。

Objective To investigate the cosmetic effects of allogeneic scleral transplantation and autologous lip mucosa and adjacent flap transfer to repair defect after orbital tumor resection.Methods 21 patients(21 eyes) with orbital defect after orbital tumor resection were selected from November 2017 to March 2019, 11 cases(11 eyes) in group A were treated with allogeneic scleral transplantation, and 10 cases(10 eyes) in group B were treated with autologous lip mucosa and adjacent flaps.The repair effect, beauty score and complication rate were observed.Results No significant difference in the length of cleft palate and cleft palate between two groups before restoration were observed(P >0.05). The difference in cleft palate length and cleft palate height after repair in group A was significantly different from that in group B(P <0.05).Before the repair, there was no significant difference between the two groups(P >0.05). The cosmetic score after repair in group A was significantly higher than that in group B(P <0.05).The incidence of complications such as infection, ptosis, suture collapse and sacral margin in group A was significantly lower than that in group B(P<0.05).Conclusion Repairing orbital tumors after resection of the defect with the application of allogeneic scleral transplantation is better, can promote the recovery of eyelid morphology and function, can also improve the cosmetic effect, it is worth promoting.