A COMBINATION OF CHEEK FLAP, CARTILAGE INSERTION, AND FAT TRANSFER ON POST-TRAUMA LOWER EYELID ECTROPION RECONSTRUCTION
Downloads
Highlights:
- This study introduces an innovative approach for post-traumatic ectropion reconstruction in children by combining Mustarde rotational cheek flap, cartilage insertion, and fat transfer.
- This method effectively addresses the challenges of cicatricial ectropion caused by injuries or burns, leading to improved, durable, and cost-effective outcomes in restoring eyelid function and volume.
Abstract:
Introduction:Ectropion correction surgery is a procedure designed to restore the anterior lamella to its anatomical position. This study aims to propose a combination of cheek flap and fat transfer as a method for post-traumatic ectropion reconstruction surgery.
Case Illustration:A 10-year-old girl presented with ectropion caused by scar formation and volume loss in the infraorbital region following a traumatic incident seven years prior. The procedures performed in this case included a Mustarde rotational cheek flap to reconstruct the scar tissue in the infraorbital region that led to the ectropion, pure ear cartilage insertion to repair the damaged tarsal plate or tarsus, and fat transfer to address the volume loss in the infraorbital area. The donor fat was harvested from the inguinal region
Discussion: The rationale for using the Mustarde rotational cheek flap, cartilage insertion, and fat transfer was based on the wide donor area, particularly in cases where the vertical dimension exceeds the horizontal dimension. This approach is believed to yield better outcomes compared to other methods, such as skin grafts. In this case, fat transfer was employed to restore the volume lost beneath the scar tissue following trauma. This combination technique is thought to be more durable and to provide superior results compared to alternative methods, while also being economically advantageous.
Conclusion: The combination of the Mustarde rotational cheek flap, cartilage insertion, and fat transfer is believed to improve the outcomes of the reconstruction procedure following scar tissue release and correction of volume loss beneath the scar.
Hakim F and Phelps PO. Entropion and ectropion. Disease-a-Month. 2020; 66 (10):101039. DOI:10.1016/j.disamonth. 2020.101039
Sidana S and Kadam S. Cicatricial ectropion of lower eyelid: a report of two cases. Journal of cutaneous and aesthetic surgery. 2021; 14(2):233-237. DOI: 10.4103/JCAS.JCAS_133_19
Skorin L and Rebecca L Ectropion: Classification, Diagnosis, and Management. Consultant. 2018; 58(6): e180. Available at https://www.consultant360.com/articles/ectropion-classification-diagnosis-and-management
Skorin L, Nate Lighthizer, Selina McGee, Richard Castillo, and Karl Stonecipher. The Ophtalmic Office Procedures Handbook. Philadelphia. Lippincott Williams and Wilkins; 2023
Choi MH, He WJ, Son KM, Choi WY, and Cheon JS. The efficacy of dermofat grafts from the groin for correction of acquired facial deformities. Archives of Craniofacial Surgery, 2020; 21(2):92. DOI: 10.7181/acfs.2020.00038
Tao JP. Plastic Surgery of the Lower Eyelids. Cham: Springer;2023. DOI:10.1007/978-3-031-36175-3
Kiran S, Khan FAA, Ali H, Kumar S, Sami W, and Khursheed RM. Surgical Correction of Ectropion: Comparison Between Full Thickness Skin Grafts and Local Flaps. Pakistan Armed Forces Medical Journal, 2022; 72(3):961-965. DOI: 10.51253/pafmj.v72i3.5348
Choi MH, He WJ, Son KM, Choi WY, and Cheon JS. The efficacy of dermofat grafts from the groin for correction of acquired facial deformities. Arch Craniofac Surg. 2020 Apr;21(2):92-98. doi: 10.7181/acfs.2020.00038. Epub 2020 Apr 20. PMID: 32380808; PMCID: PMC7206454.
Harceaga OI, Nicoara SD, Muntean V, Grigorescu D, and Muntean MV. Fat transfer for cicatricial ectropion in lamellar ichthyosis. European Journal of Plastic Surgery, 2016; 39: 57-60. DOI:10.1007/s00238-015-1167-1
Yan Y, Fu R, Ji Q, Liu C, Yang J, Yin X, et al. Surgical strategies for eyelid defect reconstruction: a review on principles and techniques. Ophthalmology and Therapy, 2022; 11(4): 1383-1408. DOI:10.1007/s40123-022-00533-8
Hötte GJ, de Keizer ROB, Sigurðsson H, and Paridaens D. Ectropion. In: Quaranta Leoni, F.M., Verity, D.H., Paridaens, D. (eds) Oculoplastic, Lacrimal and Orbital Surgery. Springer, Cham. 2024. DOI:10.1007/978-3-031-39634-2_9
Goel R. Manual of Oculoplasty. New Delhi: Jaypee Brothers Medical Publishers; 2019:352. DOI:10.5005/jp/ books/18237
Lin P, Kitaguchi Y, Mupas-Uy J, Sabundayo MS, Takahashi Y, and Kakizaki H. Involutional lower eyelid entropion: causative factors and therapeutic management. Int Ophthalmol. 2019; 39(8): 1895-1907. DOI: 10.1007/s10792-018-1004-1
Hocaoğlu E, Özden BC, Aydin H. Lower eyelid reconstruction in a paediatric face: a one-stage aesthetic approach using the versatile temporoparietal fascia flap. J Plast Reconstr Aesthet Surg. 2012;65(9):e246-9. DOI: 10.1016/j.bjps. 2012.02.025
Ko MJ, Erickson BP, Blessing NW, and David TT.The flip-back myocutaneous advancement flap for periocular reconstruction. Ophthalmic Plast Reconstr Surg. 2019;35(6):569-573. DOI: 10.1097/IOP.0000000000001377
Takaya KMD, Sakai SMD, and Kishi KMD. Treatment of Cicatricial Lower Eyelid Ectropion with Suture of Horner Muscle Combined with Fascia Transplantation. Plastic & Reconstructive Surgery-Global Open.2024; 12(3): e5675. DOI: 10.1097/GOX.0000000000005675
de Leó F, and Carrillo LFM. Using Mustardé Flap for Reconstruction of a Traumatic Facial Injury: Case Report. Modern Plastic Surgery, 2024; 14(4):51-56. DOI: 10.4236/mps.2024. 144006
Ochiai H, Yagi N, Oka A, Hirata E, Yabuki H, and Fujii M. Composite Auricular Chondrocutaneous Graft Is Useful For Lower Eyelid Reconstruction after Surgery for Cancer of the Maxilla. Global Surgery. 2016;2(4). DOI: 10.15761/GOS.1000144
Watanabe A, Katori N, Selva D, Hayashi K, and Kinoshita S. Modified auricular cartilage sling for paralytic ectropion. Journal of plastic, reconstructive & aesthetic surgery, 2015; 68(7): 902-906. DOI: 10.1016/j.bjps.2015.03.019
Xie Y, Huang RL, Wang W, Cheng C, and Li Q. Fat grafting for facial contouring (temporal region and midface). Clinics in plastic surgery, 2020; 47(1):81-89. DOI: 10.1016/j.cps.2019.08.008
Copyright (c) 2024 Ulfa Elfiah, Dicky Primadika Aprinova
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
JURNAL REKONSTRUKSI DAN ESTETIK by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- The journal allows the author to hold copyright of the article without restriction
- The journal allows the author(s) to retain publishing rights without restrictions.
- The legal formal aspect of journal publication accessbility refers to Creative Commons Attribution Share-Alike (CC BY-SA)
Jurnal Rekonstruksi dan Estetik by