Free tarsomarginal graft for large congenital coloboma repair in patients with Tessier number 10 clefts
Free tarsomarginal graft for large congenital coloboma repair in patients with Tessier number 10 clefts
复制标题
游离跗缘移植物修复 Tessier 10 号唇裂患者的大面积先天性缺损
DOI：
10.1016/j.bjps.2016.04.009
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发表时间：
2016-08-01
影响因子：
2.7
通讯作者：
Fan, Xianqun
中科院分区：
文献类型：
--
作者：
Fu, Yao;Shao, Chunyi;Fan, Xianqun
目的：本研究的目的是评估长期的结果时，一个免费的tarsomarginal移植是用来修复一个大的先天性缺损的患者Tessier数10 cleft.Materials和方法：这是一个回顾性的，干预性的病例系列。我们回顾了五名儿童（六只眼睛）的病历，他们被诊断为患有Tessier 10号裂，上眼睑缺损和睑球粘连。这些儿童于2007年5月至2012年12月期间转诊至上海市第九人民医院眼科。重建技术包括用下眼睑的游离睑板缘移植物修复上眼睑缺损，以及在睑球粘连松解后使用结膜自体移植物重建结膜穹窿。所有患儿均随访2年以上。术后上睑外形，生存能力和功能的角膜保护，和睑球粘连复发进行了assessed.Results：一个阶段的重建程序在所有的孩子。所有重建眼睑均达到了提供角膜保护和改善外观的手术目标，暴露性角膜病变明显改善，无相关的兔眼。足够的重建上穹窿，并没有明显复发的睑球粘连。结论：一个免费的tarsomarginal移植是有益的，似乎是一个足够的方法重建大眼睑缺损的儿童Tessier数10裂。睑球粘连松解与结膜自体移植重建眼表，可以同时进行眼睑修复作为一个阶段的程序。(C)2016由Elsevier Ltd代表英国整形、重建和美容外科医生协会发布。
Aim: The aim of this study was to evaluate the long-term outcome when a free tarsomarginal graft is used to repair a large congenital coloboma in patients with a Tessier number 10 cleft.Materials and methods: This was a retrospective, interventional case series. The medical records were reviewed for five children (six eyes) diagnosed as having Tessier number 10 cleft with large upper eyelid defects and symblepharon. These children were referred to the Department of Ophthalmology of Shanghai Ninth People's Hospital, between May 2007 and December 2012. Reconstructive techniques included repair of the upper eyelid defect with a free tarsomarginal graft taken from the lower eyelid, and reconstruction of the conjunctival fornix by using a conjunctival autograft after symblepharon lysis. All the children were followed up for more than 2 years. Postoperative upper eyelid contour, viability and function for corneal protection, and recurrence of symblepharon were assessed.Results: A one-stage reconstruction procedure was used in all children. All reconstructed eyelids achieved a surgical goal of providing corneal protection and improved cosmesis, with marked improvement of exposure keratopathy and no associated lagophthalmos. Adequate reconstruction of the upper fornix was obtained, and there was no obvious recurrence of symblepharon.Conclusion: A free tarsomarginal graft is beneficial and seems to be an adequate method for reconstruction of large eyelid defects in children with a Tessier number 10 cleft. Symblepharon lysis with a conjunctival autograft for reconstruction of the ocular surface can be performed at the same time as eyelid repair as a one-stage procedure. (C) 2016 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.