Facial Plast Surg 2015; 31(05): 534-538
DOI: 10.1055/s-0035-1564584
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prefabricated Composite Graft for Eyelid Reconstruction

Giovanni Nicoletti
1   Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
2   Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy
3   Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Centre, University of Pavia, Pavia, Italy
,
Omar Jaber
1   Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
2   Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy
,
Marco Mario Tresoldi
1   Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
2   Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy
,
Tommaso Pellegatta
1   Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
2   Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy
,
Angela Faga
1   Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
2   Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy
3   Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Centre, University of Pavia, Pavia, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 November 2015 (online)

Abstract

The authors propose a prefabricated chondromucosal composite graft to reconstruct full-thickness defects of the lower eyelid. The technique was used in a patient suffering from a locally invasive basal cell carcinoma of the lower eyelid, who had previously undergone an extensive submucosal nasal septum resection. One week prior to the eyelid resection, the anterior skin surface of the auricular concha was replaced with a full-thickness oral mucosa graft. One week later, a full-thickness excision of the right lower eyelid was performed and the prefabricated chondromucosal auricular graft was used to restore the posterior lamella. The anterior lamella was reconstructed with a bipedicled myocutaneous flap from the upper eyelid. Because of the patient's scheduling needs, the medial pedicle of the flap was divided 28 days later and the lateral one after further 37 days. All the procedures were performed under local anesthesia. This technique adds a simple key detail to other time-honored reliable techniques, thus outlining an extremely convenient sequence for full-thickness eyelid reconstruction. The easily prepared prefabricated chondromucosal graft might be associated with any of the previously described flaps, thus providing a versatile and reliable method of posterior lamella reconstruction.

 
  • References

  • 1 Parodi PC, Calligaris F, De Biasio F, De Maglio G, Miani F, Zeppieri M. Lower lid reconstruction utilizing auricular conchal chondral-perichondral tissue in patients with neoplastic lesions. Biomed Res Int 2013; 2013: 837536
  • 2 Fante RG, Hawes MJ. Reconstruction of the eyelids. In: Baker SR, , ed. Local Flaps in Facial Reconstruction. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2014: 387-414
  • 3 Nicoletti G, Brenta F, Malovini A, Musumarra G, Scevola S, Faga A. Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer. Mol Clin Oncol 2013; 1 (2) 390-394
  • 4 Lesavoy MA. Local incisions and flap coverage. In: Mc Carthy JG, May Jr JW, Littler JW, , eds. Plastic Surgery. Philadelphia, PA: WB Saunders; 1990: 4441-4458
  • 5 Mathijssen IM, van der Meulen JC. Guidelines for reconstruction of the eyelids and canthal regions. J Plast Reconstr Aesthet Surg 2010; 63 (9) 1420-1433
  • 6 Hughes WL. A new method for rebuilding a lower lid: report of a case. Arch Ophthalmol 1937; 17: 1008-1017
  • 7 Scuderi N, Ribuffo D, Chiummariello S. Total and subtotal upper eyelid reconstruction with the nasal chondromucosal flap: a 10-year experience. Plast Reconstr Surg 2005; 115 (5) 1259-1265
  • 8 Rampazzo A, Gharb BB, Chi Chen H. Total lower eyelid reconstruction with free posterior auricular chondrocutaneous flap. J Plast Reconstr Aesthet Surg 2010; 63 (4) e384-e386
  • 9 Matsuo K, Hirose T, Takahashi N, Iwasawa M, Satoh R. Lower eyelid reconstruction with a conchal cartilage graft. Plast Reconstr Surg 1987; 80 (4) 547-552
  • 10 Paridaens D, van den Bosch WA. Orbicularis muscle advancement flap combined with free posterior and anterior lamellar grafts: a 1-stage sandwich technique for eyelid reconstruction. Ophthalmology 2008; 115 (1) 189-194
  • 11 Baker SJ. Local Flaps in Facial Reconstruction. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2007: 403-407
  • 12 Scott JH, Symons NBB. Introduction to Dental Anatomy. 8th ed. New York, NY: Churchill Livingstone; 1977: 288-296
  • 13 Whitehouse GM, Francis IC. Eyelid reconstruction using a monopedicle flap and buccal mucosa: report of 15 cases. Aust N Z J Ophthalmol 1988; 16 (4) 295-301