Tarsoconjunctival-Skin Flap as Another Option in Correcting Ectropion for Oro-Ocular Cleft Reconstruction: Report of 2 Cases

2021 ◽  
pp. 105566562110366
Author(s):  
Magda R. Hutagalung ◽  
Indri L. Putri ◽  
Siti I. Wahdini ◽  
Ishandono Dachlan ◽  
Lobredia Zarasade
Keyword(s):  
Surgical Procedures ◽  
Skin Flap ◽  
Lower Eyelid ◽  
Facial Anomalies ◽  
Facial Clefts

Facial clefts are rare facial anomalies. Among them, oro-ocular cleft remains a challenging malformation due to ectropion of the inferior palpebra which can constitute an emergency when the patient's globe is exposed leading to exposure keratitis and blindness. Here we report surgical procedures to correct lower eyelid ectropion using tarsoconjunctival-skin flap performed on 2 cases. In conclusion, tarsoconjunctival-skin flap can be provided to effectively correct lower eyelid ectropion and is a better option when nose correction is not involved simultaneously.

A Novel Surgical Method of Reconstruction for Proboscis Lateralis: A Case Report and Review of the Literature

2021 ◽  
pp. 105566562110531
Author(s):  
Etkin Boynuyogun ◽  
Figen Ozgur
Keyword(s):  
Skin Flap ◽  
Distal Segment ◽  
Lower Eyelid ◽  
Review Of The Literature ◽  
Medial Canthus ◽  
Craniofacial Anomaly ◽  
Adjacent Structures ◽  
The Right ◽  
Relationship Of ◽  
Proboscis Lateralis

Proboscis lateralis (PL) is a rare congenital craniofacial anomaly and it is represented by rudimentary, tube-like nasal structure measuring 2–3 centimetre (cm) length and generally attaches to medial canthal region. A 22-month-old male patient was referred to our clinic with a PL hanging from the right medial canthus and a coloboma on the medial third of the right lower eyelid. Physical examination revealed that the PL was 4 cm long and 1.5 cm in diameter. There was a blind cavity with dimple at its distal segment. The right side of the nose and the nasal airway was aplastic. Before surgical correction, neuroradiological evaluation should be performed to obtain the characteristics and relationship of the lesion with adjacent structures and associated anomalies Many reconstructive options have been described in the literature, however, these options are insufficient to obtain natural contour and define alar crease, especially. We described the laterally-based skin flap from the medial wall of the left heminose and adapted to the lateral edge of the de-epithelialized skin of PL for defining supra-alar crease.

Outcomes after surgical resection of lower eyelid tumors and reconstruction using a septal chondromucosal graft and an upper eyelid skin flap

2016 ◽  
Vol 94 ◽  
Author(s):  
S. Lemaitre ◽  
C. Levy-Gabriel ◽  
B. Couturaud ◽  
S. Gardrat ◽  
N. Cassoux ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Skin Flap ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Eyelid Tumors ◽  
Eyelid Skin

scholarly journals Pretarsal orbicularis oculi muscle tightening with skin flap excision in the treatment of lower eyelid involutional entropion

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianhao Cai ◽  
Yuansheng Zhou ◽  
Wenjuan Lv ◽  
Wenxia Chen ◽  
Weihao Cai ◽  
...  
Keyword(s):  
Skin Flap ◽  
Lower Eyelid ◽  
Orbicularis Oculi Muscle ◽  
Modified Technique ◽  
Recurrence Rates ◽  
Orbicularis Oculi ◽  
Excess Skin ◽  
Repeated Surgery ◽  
Involutional Entropion ◽  
Correction Surgery

Abstract Background To evaluate a modified technique for involutional entropion correction in a retrospective cohort study. Methods The patients with involutional entropion eyelid were corrected by tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid. The patients received correction surgery from April 2013 to March 2019 were followed up for more than 6 months postoperatively. The outcome measures included the complications and the recurrence rates. Results Total 152 patients (169 eyes) were included. The mean follow-up period was 29.6 months (range: 6–36 months). Postoperative ectropion (over-correction) was observed in 1 patient with 1 eyelid (0.59%); yet, no further surgery was needed for this patient. Recurrence of entropion was found in 1 patient (0.59%). The patient with recurrent entropion received repeated surgery with the same method and achieved a good eyelid position. Conclusions This study demonstrated that tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid could be an effective surgical method to correct lower eyelid involutional entropion. This method is technically easy with a low recurrence rate and not associated with significant complications in Asians.

Anterior urethral reconstructions

1994 ◽  
Vol 61 (1) ◽  
pp. 11-18
Author(s):  
E. Austoni ◽  
F. Mantovani ◽  
F. Colombo ◽  
O. Fenice ◽  
G. Mastromarino ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Skin Flap ◽  
Bladder Mucosa ◽  
Modified Technique ◽  
Urethral Strictures ◽  
Multi Stage ◽  
End To End ◽  
The One ◽  
The University

In the surgical treatment of urethral strictures many techniques have been proposed in the last 30 years. Nowadays, only some of them are currently used, because of complications correlated to these surgical procedures. Of course, our School has also changed indications for surgical procedures in urethral strictures. We can use two different kinds of surgical technique; excision of the stricture with an end-to-end anastomosis or urethroplasty. At the Institute of Urology of the University of Milan, 84 patients underwent end-to-end anastomosis: the 12 months follow-up showed 6 relapsed strictures, 1 fistula and 5 penile ventral flexures. In the field of multi-stage urethroplasty our greatest experience is related to the scrotal inlay technique (144 patients: 36 relapsed strictures, 65 phlogoses, 44 stones), while 18 patients underwent the procedure by the use of free epidermal mesh graft (1 fistula, 2 penile flexures, 2 necrosis of the graft). Concerning the one-stage procedures, the bladder mucosa graft seems to be reliable, and the complications observed were the following: 2 relapsed strictures, 3 fistules, 1 penile flexure; the lip mucosa graft represents a possible alternative: using this technique in 8 patients we had 2 recurrent strictures and 1 fistula. Recently we proposed a modified technique using a tubularlzed penile skin flap for complex, recurrent, extended bulbo-membranous strictures. 24 pts. underwent this surgical procedure. Only two stricture relapses have been found. The first four operated pts. had urethrocystograms which revealed a neourethra exceeding the normal caliber and this was resolved in consecutive cases by reducing the size of the flap.

Face-Lifting Techniques

2011 ◽  
Author(s):  
David E.E. Holck ◽  
Joel Kopelman
Keyword(s):  
Skin Flap ◽  
Subcutaneous Fat ◽  
Lower Eyelid ◽  
Nasolabial Fold ◽  
Eyelid Skin ◽  
The Face ◽  
Mimetic Muscles ◽  
Age Appropriate ◽  
Nasolabial Folds ◽  
Lifting Techniques

Facial rhytidectomy is a rejuvenative surgical procedure designed to improve the aging changes in the lower third of the face and neck. It can significantly improve jowling, the jaw line, and the portion of the neck from the hyoid bone to the jaw line (the cervicomental angle). It is less successful at improving the midface or nasolabial folds. Rhytidectomy optimizes the age-appropriate aesthetic but does not stop the normal aging progression after surgery. While a wellperformed rhytidectomy is extremely gratifying for both patient and surgeon, it is elective and invasive, with prolonged rehabilitation and potential morbidity. Complications are poorly tolerated, and therefore pitfalls should be meticulously avoided. Fundamental steps in facial rhytidectomy include incision planning, skin flap dissection, addressing the superficial musculo-aponeurotic system (SMAS) and platysma, liposuction or direct lipectomy, skin redraping, and wound closure. These are standard in lower-third facial and neck rejuvenation. Face lifting is an imperfect procedure: the surgeon takes advantage of camouflaged incisions and healing patterns to obtain optimal rejuvenation. The facial anatomy of the lower third of the face and neck is complex but may be best viewed in a layered approach. Facial skin varies in thickness, with eyelid skin being the thinnest and cheek skin the thickest. The skin of the face is nourished via a dermal plexus, which must be maintained in rhytidectomy surgery. Beneath the skin lies facial subcutaneous fat. This fat is lobulated and enclosed by fibrous septa, which connect the superficial fascia to the dermis. The thickest portion of subcutaneous fat is the malar fat pad, bounded by the infraorbital rim above, the nasolabial fold medially, and the zygomaticus major muscle laterally. Minimal subcutaneous fat is located in the lower eyelid region and in the perioral region. Below the level of the subcutaneous fat is the SMAS. This fibromuscular sheet is continuous with the superficial temporalis fascia and galea cranially and the platysma muscle caudally. The SMAS envelops and connects the superficial mimetic muscles to the dermis, expanding the range of facial expression to the skin via distribution of force.

Three-Dimensional Computer Graphics for Surgical Procedure Learning: Web Three-Dimensional Application for Cleft Lip Repair

2006 ◽  
Vol 43 (3) ◽  
pp. 266-271 ◽  
Author(s):  
Masahiro Kobayashi ◽  
Tatsuo Nakajima ◽  
Ayako Mori ◽  
Daigo Tanaka ◽  
Toyomi Fujino ◽  
...  
Keyword(s):  
Computer Graphics ◽  
Surgical Procedures ◽  
Cleft Lip ◽  
Skin Flap ◽  
3D Structure ◽  
Three Dimensional ◽  
Image Data ◽  
3D Animation ◽  
3D Ct ◽  
Flap Design

Objective In surgical procedures for cleft lip, surgeons attempt to use various skin incisions and small flaps to achieve a better and more natural shape postoperatively. They must understand the three-dimensional (3D) structure of the lips. However, they may have difficulty learning the surgical procedures precisely from normal textbooks with two-dimensional illustrations. Recent developments in 3D computed tomography (3D-CT) and laser stereolithography have enabled surgeons to visualize the structures of cleft lips from desired viewpoints. However, this method cannot reflect the advantages offered by specific surgical procedures. To solve this problem, we used the benefits offered by 3D computer graphics (3D-CG) and 3D animation. Design and Results By using scanning 3D-CT image data of patients with cleft lips, 3D-CG models of the cleft lips were created. Several animations for surgical procedures such as incision designs, rotation of small skin flaps, and sutures were made. This system can recognize the details of an operation procedure clearly from any viewpoint, which cannot be acquired from the usual textbook illustrations. This animation system can be used for developing new skin-flap design, understanding the operational procedure, and using tools in case presentations. The 3D animations can also be uploaded to the World Wide Web for use in teleconferencing.

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