Full-thickness reconstruction of the eyelid with rotation flap based on orbicularis oculi muscle and palatal mucosal graft: long-term results in 12 cases.
BACKGROUND
Numerous techniques have been proposed for full-thickness eyelid reconstruction. Previously, we reported full-thickness eyelid reconstruction with a rotation flap based on the orbicularis oculi muscle and palatal mucosal graft. Here, we report long-term results in 12 cases.


METHODS
After confirmation of defect size, the mucosal defect was covered with a split-thickness palatal mucosal graft. The rotation flap was elevated at the lateral orbital region and the skin defect was covered. Seven cases were reconstructions after tumour excision and five cases were for lagophthalmos after trauma. In cases of tumour excision, five cases had full defects of the lower eyelid and two cases had defect of the lower eyelid lateral to the punctum. In the cases of lagophthalmos, four cases had upper eyelid contracture and one had lower eyelid contracture.


RESULTS
Postoperatively, one case showed severe venous congestion of the flap, which led to scleral show. In the other 11 cases, there were no complications, and cosmetic results were excellent.


CONCLUSIONS
With our method, cosmetically good results can be obtained in either upper or lower eyelids. In the rotation flap based on the orbicularis oculi muscle, the undermined area is small, invasion is minimal, and the effects of scar contracture can be minimised. Minimal shrinkage of palatal mucosal grafts prevents the reconstructed eyelid from sagging. In only one case, poor design of the flap led to flap congestion. However, this complication can be avoided with the proper design.
Miyamoto
Junpei
J
Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan. j-miya@rr.iij4u.or.jp
Nakajima
Tatsuo
T
Nagasao
Tomohisa
T
Konno
Eri
E
Okabe
Keisuke
K
Tanaka
Takara
T
Fujii
Shunji
S
Kobayashi
Hisashi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D004954:Esthetics; D005131:Eye Injuries / Q000175:diagnosis / Q000601:surgery; D005142:Eyelid Neoplasms / Q000473:pathology / Q000601:surgery*; D005143:Eyelids / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery / Q000637:transplantation; D009801:Oculomotor Muscles / Q000601:surgery / Q000637:transplantation; D010156:Palatal Muscles / Q000601:surgery / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing / Q000502:physiology