Surgical outcomes of Tenzel rotational flap in upper and lower lid reconstruction without repair of posterior lamella: A modified approach.
Surgical outcomes of Tenzel rotational flap in upper and lower lid reconstruction without repair of posterior lamella: A modified approach.
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DOI：
10.22336/rjo.2021.70
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发表时间：
2021-10
期刊：
影响因子：
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通讯作者：
Agarwal SS
中科院分区：
文献类型：
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作者：
Mandal SK;Maitra A;Ganguly P;Agarwal SS
目的：评价Tenzel旋转皮瓣在恶性肿瘤上、下睑重建术中的疗效和实用性，确定上睑重建术及肿瘤复发后的解剖方向、功能、美容效果，观察上睑和穹窿的状态。方法：对30例患者进行为期18个月的前瞻性、非比较性、介入性临床研究。本研究遵循严格的纳入和排除标准。评价参数为术前、术后上睑提肌（LPS）作用、术前、术后边缘反射距离（MRD-1）值、术前、术后中央垂睑裂高度（PFH）、术前创面缺损表达百分比计算。所有病例后椎板均未修复。它是自动形成或加强的。结果：FNAC诊断皮脂腺细胞癌为14/30，病理诊断为17/30。上眼睑MRD-1术前均值为-1.09±1.54 mm，术后均值为4.02±0.36 mm。LPS对上睑肿瘤的术前平均作用为4.35±0.96 mm ~术后12.42±1.24 mm。上睑肿瘤术前平均上睑中央开孔4.76±0.88 mm，术后平均上睑中央开孔10.47±0.88 mm。上眼睑Tenzel重建的平均切口长度为8.16±0.61 mm，下眼睑Tenzel重建的平均切口长度为9.27±0.87 mm。所有病例后板生长正常。此外，不需要任何加强程序。结论：恶性肿瘤切除后上睑缺损40% ~ 60%，下睑缺损40% ~ 70%，采用该术式可有效修复。标本的组织病理学诊断比FNAC更准确。未对后板进行修复。不需要额外的外科手术。因此，手术时间明显缩短。术后所有患者上眼睑隆起良好，眼睑闭合良好，视力和功能恢复良好。美观的外观是优秀的。
Aim: To evaluate the efficacy and usefulness of Tenzel rotational flap in upper and lower lid reconstruction in malignant tumors, to determine the anatomical alignment, functional, and cosmetic outcome after lid reconstruction and recurrence of the tumor and to observe the canthal and fornix status. Methods: Prospective, non-comparative,interventional clinical study of 30 patients over a period of 18 months. The study was conducted with strict inclusion and exclusion criteria. Evaluation parameters were LPS (Levator palpebrae superioris) action Pre and post operative, MRD-1 (Margin Reflex Distance-1) values pre and post operative, central vertical palpebral fissure height (PFH) pre and post operative,and the calculation of the created defect express in percentage preoperatively. None of the case posterior lamina was repaired. It formed or strengthened automatically. Results: The diagnosis of Sebaceous cell carcinoma was 14/30 by FNAC and 17/30 by histopathology. The mean MRD-1 pre-operatively was -1.09 ± 1.54 mm to 4.02 ± 0.36 mm postoperatively in the upper lid. The mean LPS action pre-operatively was 4.35 ± 0.96 mm to 12.42 ± 1.24 mm postoperatively in the upper lid tumor. The mean pre-operative central palpebral aperture was 4.76 ± 0.88 mm and post-operative central palpebral aperture was 10.47 ± 0.88 mm in the upper lid tumor. The mean incision length was 8.16 ± 0.61 mm in upper lid and 9.27 ± 0.87 mm in lower lid Tenzel reconstruction respectively. In all the cases, posterior lamella grew normally. In addition, no strengthening procedure was required. Conclusion: This reconstructive procedure was useful to repair 40%-60% of the upper lid and 40%-70% created a defect in the lower eyelid after the removal of the malignant tumor. Histopathological diagnosis of the specimen was more accurate than FNAC. No repair of posterior lamella was made. No extra surgical procedure was needed. Thus, the surgical procedure time was markedly reduced. After the surgery, all the patients presented a good uplift of the upper lid, good closure of the eyelids, and were visually and functionally well rehabilitated. The aesthetic appearance was excellent.