Autologous tissue reconstruction of tarsal plate combined with temporal flap in repairing full-thickness lower eyelid defect / 中南大学学报(医学版)

Objective:To evaluate the clinical effect of combination of autologous tissue reconstruction of tarsal plate with temporal flap on repair of full-thickness lower eyelid defect.Methods:Eleven patients (11 eyes) underwent hard palate mucosa or ear cartilage combined the emporal flap with the orbicularis oculi muscle to repair full-thickness defect ofpalpebra inferior.Of the 11 patients,6 had more than 75％ eyelid defect area,and 5 had more than 50％ eyelid defect area.Results:All 11 eyes closed completely,with no entropion or ectropion,and returned to normal basically.Postoperative follow-up was performed for 6 months to 5 years,3 years and 4 months on average.The function and form of eyelid remained stable.Infection,leakage or contracture was not found on reconstruction tarsus.Conclusion:Reconstruction of eyelid with autogenous hard palate mucosa or ear cartilage combined the emporal flap with the orbicularis oculi muscle is a simple,convenient and effective method.

Effect of low-level laser therapy on experimental wounds of hard palate mucosa in mice.

Under general anesthesia and sterile conditions, incision wound was induced in the hard palate mucosa of adult male mice. The wounds of groups 1 and 2 were irradiated daily with He-Ne laser at 3 and 7.5 J/cm2 for 120 and 300 s, respectively, while the incision wound of group 3 not exposed served as controls. On day 3 of injury, the laser-treated wounds contained significantly lower neutrophils than the wounds in the control group. By day 7 after injury, the laser-treated wounds contained significantly more fibroblasts and at the same time contained significantly fewer macrophages. In conclusion, an acceleration of the wound healing process of experimental wounds in the hard palate mucosa of mice at low-level laser therapy with a He-Ne laser at energy densities of 3 and 7.5 J/cm2 was observed.

Correction of Lower Eyelid Retraction with Autogenous Hard Palate Mucosa : 2 Case Report

PURPOSE: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. METHODS: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. RESULTS: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. CONCLUSIONS: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.

Hard Palate Mucosa Grafts for Lower Lid Retraction

Lower eyelid retraction is usually managed by recession of the lower lid retractors and interposition of a spacer graft including ear cartilage, nasal septal cartilage, donor sclera or autogenous tarsoconjunctiva.We have used hard palate mucosa as a spacer in 10 patients (11 eyelids)with lower lid retraction.Average age at operation was 36 years with the range of 10 years to 59 years.Causes of the lower lid retraction were thyroid ophthal-mopathy (4 eyelids), strabismus surgery (2 eyelids), entropion repair (2 eye-lids), eyelid infection (2 eyelids), and trauma (1 eyelid).Of 11 eyelids, 7 eye-lids were combined with entropion due to the shortage of posterior lamella. The follow-up period ranged from 3 to 45 months (mean 17 months).Surgi-cal results in all 11 eyelids were satisfactory.There was no complication in donor site.Hard palate closely approximates lower lid tarsus in terms of contour, thickness, and stiffness, provides a mucosal surface and shows only minimal shrinkage. We suggest hard palate mucosal grafts as one of the best available spacer material for the treatment of lower lid retraction.

Hard Palate Mucosa Grafts for Cicatricial Entropion

Various surgical procedures have been described for correction of cicatricial entropion of the eyelid. Many of them fail to provide long-term correction and anatomic alteration which is the excessive scarring of the posterior lamella of the eyelid. Hard palate mucosa grafts provide a smooth mucosal surface to the cornea and buttress the scarred tissues of the posterior eyelid. Ten eyelids of eight patients underwent eyelid margin reconstruction using hard palate mucosa graft. Cicatricial entropions were secondary to chemical burn(2 patients), herpes zoster (1 patient), atopic dermatitis (1 patient), toxic epidermal necrolysis (1 patient) and Stevens-Johnson syndrome (3 patients). Surgical results in ten eyelids were satisfactory. The grafts contracted minimaIly, and the palatal donor site healing was completed in 2-4 weeks.