Reconstruction of the lower eye lid with a rotation-advancement tarso-conjunctival cheek flap

[摘要] The repair of full-thickness defects of the lower eyelids poses a challenge because agraft in combination with a flap is typically used to replace either the posterior oranterior lamella. This often results in aesthetically and functional unsatisfactoryoutcomes. A rotation-advancement tarso-conjunctival cheek flap, which reconstructsboth posterior and anterior lamella with vascularized tissue similar to the native eyelid,is described.Nine patients underwent reconstruction with a rotation-advancement tarso-conjunctivalcheek flap. The indications, complications and outcomes were evaluated. The follow-uptime ranged from 6 to 60 months with an average of twenty three months.The main indication for use of this flap is full-thickness defects of the lower eyelidbetween 25 – 75 %, typically after tumour ablation. All the patients had a functional andaesthetically satisfactory outcome. One patient underwent a revision canthoplasty.The rotation-advancement tarso-conjunctival cheek flap adheres to basic plastic surgeryprinciples resulting in a satisfactory outcome; (a) Vascularized tissue is used toreconstruct the defect. (b)The flap composition is similar to the native eyelid i.e. replacelike with like. (c) The flap makes use of tissue that is excess and therefore limits donormorbidity.

[发布机构] Stellenbosch University