Clinical use of a new axial chondro-mucosal flap in wide full-thickness eyelid reconstructions.
OBJECTIVE
Full thickness reconstruction of more than half of an eyelid, mainly of the upper one, is a challenge for the surgeon. In 1992, for the first time, the authors reported the use of an axial chondro-mucosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 18 patients operated on using the above technique during the period June 1991-March 1997.


METHODS
Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, length of the palpebral rim, rim opening, levator function, an aesthetic balance of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months.


RESULTS
The axial chondro-mucosal flap was clinically viable in all patients. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm. levator function (mean 13 mm) was shown.


CONCLUSIONS
The authors discuss their complications and results and feel that this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstruction, for wide defects when the use of other flaps is compromised.
University of Rome La Sapienza, Department of Plastic Surgery, Italy.
N
N
Scuderi
C
C
Rubino
E
E
Bertozzi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000637:transplantation*; D009300:Nasal Septum / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome