复合皮瓣修复恶性肿瘤术后眼睑全层缺损疗效观察

Efficacy of full-thickness eyelid defects after transcomposite flaps transplantation for malignant tumor resection

目的探讨眼周带蒂皮瓣联合硬腭黏膜、睑板或骨膜组成的复合皮瓣修复眼睑恶性肿瘤术后全层缺损的疗效。方法回顾性病例研究。对21例(21只眼)眼睑恶性肿瘤切除术后中、重度全层眼睑缺损,根据其缺损范围、位置,个性化设计复合皮瓣修进行修复。随访包括:眼睑形态(睑缘弧度),功能(眼睑闭合状况),眼表改变(角膜荧光素染色)。结果全部患者随访6个月至3年,平均9个月,所有患者睑缘弧度流畅,闭合功能佳,角膜上皮早期点状缺损,经补充人工泪液后明显好转。结论对于中、重度眼睑全层缺损,眼周带蒂皮瓣联合硬腭黏膜、睑板、骨膜组成的复合皮瓣进行修复不失为一种有效且经济实惠的方法。

Objective To investigate the efficacy of pedicled local flaps combined with hard palate mucosa,tarsus palpebrarum or periorbital membrane for reconstructing the full-thickness eyelid defects after malignant tumor resection.Methods Retrospective case study.A total of 21 patients(21 eyes)with moderate to severe full-thickness eyelid defect after eyelid malignant tumor resection were personalized reconstructed with the composite flaps according to the range and location of eyelid defect.Contents of follow-up included eyelid shape(eyelid margin radian),function(eyelid closure),ocular surface changes(corneal fluorescein staining).Results Patients were followed from 6 to 36 months(mean follow-up period was 9 months).After surgery,all patients received smooth curvature of the eyelid,well function of eye closure and opening during the follow-up..The early corneal epithelial punctate defects were significantly improved than that before the surgery after artificial tear supplement.Conclusions Pedicled local flaps combined with hard palate mucosa,tarsus palpebrarum or periorbital membrane was an effective and economical in reconstructing the moderate to severe full-thickness eyelid defectsis.