Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2025
Success of Myocutaneous Flaps Without Posterior Lamellar Reconstruction for Large Full-Thickness Eyelid Mohs Defects.
СтатьяНазвание и аннотация: Перевод в очереди
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Luckett John P, Kates Malcolm M, Long John A, Vicinanzo Matthew G
Аннотация
BACKGROUND: For full-thickness Mohs eyelid defects, closure involves reconstruction of the posterior lamella (conjunctiva and tarsus) and anterior lamella (skin and orbicularis muscle).
OBJECTIVE: This study examines the necessity of dedicated posterior lamellar reconstruction in the repair of large, full-thickness eyelid defects based on functional and histologic analysis of the posterior margin without dedicated reconstruction of the posterior mucosa.
METHODS: A case series of consecutive large Mohs eyelid defects (>50% loss of palpebral conjunctiva) repaired with myocutaneous flaps without dedicated posterior mucosal reconstruction were reviewed. Postoperative complaints were recorded. Biopsies of the posterior eyelid were reviewed from 4 patients during scheduled 4- to 6-week secondary separation of interpolated flaps or debulking.
RESULTS: Twenty-six cases were identified, of which 16 (62%) lost >90% of the involved eyelid. A variety of flaps were employed (paramedian/glabellar, Fricke, nasolabial rotation, Mustarde) with good outcomes. Complications were uncommon and infrequent. All 4 biopsy specimens showed "squamous epithelium," "conjunctival epithelium," or "mucosa" without evidence of keratinization.
CONCLUSION: This series suggests that posterior mucosa reconstruction may not be necessary in cases of full-thickness eyelid defect repair as large myocutaneous flaps may act as a matrix for de novo regeneration, or extension, of conjunctival-like squamous epithelium on the posterior eyelid.
OBJECTIVE: This study examines the necessity of dedicated posterior lamellar reconstruction in the repair of large, full-thickness eyelid defects based on functional and histologic analysis of the posterior margin without dedicated reconstruction of the posterior mucosa.
METHODS: A case series of consecutive large Mohs eyelid defects (>50% loss of palpebral conjunctiva) repaired with myocutaneous flaps without dedicated posterior mucosal reconstruction were reviewed. Postoperative complaints were recorded. Biopsies of the posterior eyelid were reviewed from 4 patients during scheduled 4- to 6-week secondary separation of interpolated flaps or debulking.
RESULTS: Twenty-six cases were identified, of which 16 (62%) lost >90% of the involved eyelid. A variety of flaps were employed (paramedian/glabellar, Fricke, nasolabial rotation, Mustarde) with good outcomes. Complications were uncommon and infrequent. All 4 biopsy specimens showed "squamous epithelium," "conjunctival epithelium," or "mucosa" without evidence of keratinization.
CONCLUSION: This series suggests that posterior mucosa reconstruction may not be necessary in cases of full-thickness eyelid defect repair as large myocutaneous flaps may act as a matrix for de novo regeneration, or extension, of conjunctival-like squamous epithelium on the posterior eyelid.