FULL THICKNESS LOWER EYELID RECONSTRUCTION WITH LABIAL MUCOSA, CONCHAL CARTILAGE AND VY CHEEK ADVANCEMENT FLAP- A RETROSPECTIVE STUDY

Nupur Kapoor; Rahul Yadav

Volume : X, Issue : VII, July - 2020

FULL THICKNESS LOWER EYELID RECONSTRUCTION WITH LABIAL MUCOSA, CONCHAL CARTILAGE AND VY CHEEK ADVANCEMENT FLAP- A RETROSPECTIVE STUDY

Nupur Kapoor, Rahul Yadav

Abstract :

Objectives: To assess efficacy and long term surgical outcome of lower eyelid reconstruction with labial mucosa, conchal cartilage and VY cheek advancement flap in patients with more than 75% full thickness lower eyelid defect. Material and Methods: The study includes 20 patients (12 males and 8 females, mean age 51.95, range 42 to 63 years) that underwent surgery from Feuary, 2018 to November, 2019. The most common etiology was trauma (60%), followed by neoplasm (basal cell carcinoma) (30%) and full thickness burn (10%). Eyelid defects were repaired in three layers as– innermost, labial mucosal graft middle layer, conchal cartilage graft and the outermost layer, VY cheek advancement flap. Results: Mean hospitalization was 2.80 days. Patients were followed by both surgical and ophthalmic specialists weekly for first month, then monthly upto 6 months to assess surgical outcomes and patient satisfaction. All grafts adhered completely. There was good lid symmetry, aesthetics, patient satisfaction and proper eyelid function. There was no ectropion and entropion of lid, flap necrosis, donor site morbidity and no recurrence in neoplasm cases. There was mild wound infection in 1 case, mild congestion in 2 cases, and mild edema in 3 cases which were treated conservatively. Conclusion: This technique offers thin pliable skin, which blends well with the contour of the recipient site with superior soft tissue characteristics, predictable innervation for restablishing local sensation, easy to harvest; all grafts can be dissected simultaneously. Hence, this technique provides good functional lid reconstruction with tissues similar to eyelid.