Eyelid Reconstruction

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Lateral Cantholysis Split upper and lower canthal tendons Detach lower limb (upper limb) Angle skin incision superiorly Anchor muscle layer to periosteum after closure of defect Lateral Cantholysis 24
C: If lateral cantholysis is not adequate for closure, a skin flap can be designed with the incision extended onto the cheek or with a ―back-cut‖ of the flap as shown • Advancement of this flap along with rotation of the conjunctiva generally allows closure of defects, in some cases up to nearly onehalf of the lower lid Tenzel Rotational Flap Semicircular musculocutaneous flap Defects up to 60% Flap must arch upward Fixation of muscle to periosteum superior to canthal attachment avoids droop of lid 25
Page 1 and 2: Eyelid Reconstruction Introduction
Page 3 and 4: Anatomy Tarsus - Dense, fibrous ti
Page 5 and 6: Anatomy Orbital Septum - Fascial b
Page 7 and 8: • Lower - marginal artery • Up
Page 9 and 10: • V - median palpebral arterial v
Page 11 and 12: Anatomy Anatomy 11
Page 13 and 14: Anatomy Lateral canthal tendon - l
Page 15 and 16: Anatomy Lacrimal Excretory Pump Lac
Page 17 and 18: Eyelid Reconstruction • Skin graf
Page 19 and 20: Lower Eyelid Reconstruction PARTIAL
Page 21 and 22: Direct Closure 30% defects in youn
Page 23: The “extensile” approach: A:
Page 27 and 28: Mustarde Rotational Cheek Flap Goo
Page 29 and 30: • Over correction in the vertical
Page 31 and 32: Free Tarsal Graft Tripier bipedicle
Page 33 and 34: Hughes Procedure (continued) ―Use
Page 35 and 36: ― Medial canthal reconstruction u
Page 37 and 38: • An excellent flap for local cov
Page 39 and 40: Sliding Tarsoconjunctival Flap Iso
Page 41 and 42: Posterior Lamellar Graft with Local
Page 43 and 44: Pedicle Flap From Lower Lid Full-th
Page 45 and 46: Lateral Canthal Reconstruction Late
Page 47 and 48: Medial Canthal Reconstruction Relat
Page 49 and 50: CORRECTION OF PTOSIS • When deali
Page 51 and 52: • Neurogenic ptosis includes CN I
Page 53 and 54: • Previous problems:excessive tea
Page 55 and 56: B: Fascia is inserted between the o
Page 57 and 58: Mild/Moderate ptosis with fair to g
Page 59 and 60: Mustarde’s “split-level” tars
Page 61 and 62: • The usual amount of plication i
Page 63 and 64: ― Aesthetic eyelid ptosis correct
Page 65 and 66: • Loss of eyelashes: may occur, p
Page 67 and 68: Entropion Correction of congenital
Page 69 and 70: Entropion Correction of involution
Page 71 and 72: Entropion Correction of cicatricia
Page 73 and 74: Ectropion Congenital - Insufficien
Page 75 and 76:
Ectropion Correction of paralytic
Page 77 and 78:
Ectropion Correction of cicatricia
Page 79 and 80:
Ectropion Correction of involution
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Eyelid Reconstruction

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