眼睑恶性肿瘤切除术后缺损一期修复19例临床研究

Clinical Study of One-stage Repair Plastic Surgery for Eyelid Malignant Tumor in 19 Cases

[目的]探讨眼睑恶性肿瘤广泛切除后所致眼睑及周围组织缺损的一期修复。[方法]19例眼睑恶性肿瘤根据不同类型,选用最佳距离切除。在冰冻组织学监控下证实切缘无瘤者,根据缺损部位及大小采用不同皮瓣一期修复眼睑大面积缺损(25mm×25mm～65mm×60mm)。[结果]1例皮瓣远端部分坏死,1例表皮坏死。所有病例均取得较好外观,均保存视力。1例死于局部复发,1例死于远处转移。[结论]不同皮瓣一期修复眼睑广泛恶性肿瘤切除后的大范围缺损,可获得较好的外形及功能恢复。耳后皮瓣具有血供可靠,供瓣区隐蔽,厚薄适中,操作方便等优点,术后形态恢复较满意,是修复眼睑大面积缺损的一个理想选择。

To investgate the repair approaches for the eyelid defects following extensive excision for eyelid malignant tumor.The optimal distance incision varied according to the type of the tumor in19cases of eyelid malignant.The surgical margin was checked with frozen sections in each case.Skin flaps were used to cover the large defects according to the varied area and size of defects(the smallest defect was25mm×25mm,the largest one was65mm×60mm).Partial necrosis at the end of flap and superficial skin necrosis occurred in one case each respectively.Good cosmetic results were obtained and visual function was preserved in all cases.Two cases died of recurrence or metastasis.[Conclusion]Skin flaps can be used to repair the extensive eyelid defects.Because of retroauricular island flap with and blood supply,inconspicuous ness,fitting thickness and easiness to perform,it is the ideal choice for repairing the extensive eyelid defects.