Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Early cicatricial lagophthalmos release with pentagonal wedge resection of the scar, fat redistribution, and full-thickness skin grafting

  • Chung, Chan Min (Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Tak, Seung Wan (Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lim, Hyoseob (Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Cho, Sang-Hun (Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Jong Wook (Department of Plastic and Reconstructive Surgery, Hallym University Hangang Sacred Heart Hospital)
  • Received : 2019.10.03
  • Accepted : 2019.11.04
  • Published : 2020.02.20
Download PDF
⟨ Previous Next ⟩

Abstract

The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

Keywords

References

  1. Rucker JC. Normal and abnormal lid function. Handb Clin Neurol 2011;102:403-24. https://doi.org/10.1016/B978-0-444-52903-9.00021-2
  2. Chiummariello S, Calzoni C, Pica A, Desgro MD, Alfano C. Reconstruction of the traumatic eyelid injuries: a 6-years experience. Ann Ital Chir 2013;84:73-6.
  3. Espinoza GM, Prost AM. Upper eyelid reconstruction. Facial Plast Surg Clin North Am 2016;24:173-82. https://doi.org/10.1016/j.fsc.2015.12.007
  4. Yesiloglu N, Sirinoglu H, Sarici M, Temiz G, Guvercin E. A simple method for the treatment of cicatricial ectropion and eyelid contraction in patients with periocular burn: vertical V-Y advancement of the eyelid. Burns 2014;40:1820-1. https://doi.org/10.1016/j.burns.2014.08.024
  5. Morley AM, deSousa JL, Selva D, Malhotra R. Techniques of upper eyelid reconstruction. Surv Ophthalmol 2010;55:256-71. https://doi.org/10.1016/j.survophthal.2009.10.004
  6. Vrcek I, Chou E, Blaydon S, Shore J. Wingtip flap for reconstruction of full-thickness upper and lower eyelid defects. Ophthalmic Plast Reconstr Surg 2017;33:144-6. https://doi.org/10.1097/iop.0000000000000814
  7. Lee JH, Kim YD, Woo KI, Johnson ON 3rd. Preaponeurotic fat advancement in levator recession for treatment of upper eyelid retraction. Plast Reconstr Surg 2015;135:680e-690e. https://doi.org/10.1097/PRS.0000000000001099
  8. Zlatarova ZI, Nenkova BN, Softova EB. Eyelid reconstruction with full thickness skin grafts after carcinoma excision. Folia Med (Plovdiv) 2016;58:42-7. https://doi.org/10.1515/folmed-2016-0006
  9. Rathore DS, Chickadasarahilli S, Crossman R, Mehta P, Ahluwalia HS. Full thickness skin grafts in periocular reconstructions: long-term outcomes. Ophthalmic Plast Reconstr Surg 2014;30:517-20. https://doi.org/10.1097/IOP.0000000000000237
  10. Shorr N, Goldberg RA, McCann JD, Hoenig JA, Li TG. Upper eyelid skin grafting: an effective treatment for lagophthalmos following blepharoplasty. Plast Reconstr Surg 2003;112:1444-8. https://doi.org/10.1097/01.PRS.0000081477.02812.C9
  11. Son D, Harijan A. Overview of surgical scar prevention and management. J Korean Med Sci 2014;29:751-7. https://doi.org/10.3346/jkms.2014.29.6.751