Reconstruction of large upper XXXX with a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft.

@entity1 @entity39 @entity5 @entity2687 @entity3066
PURPOSE: To review and present the results of a one-step method employing a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft for reconstruction of large upper @entity3066 after @entity5 surgery. METHODS: This was a retrospective case-series of 8 @entity1 who underwent reconstruction of the upper eyelid after @entity5 removal. The horizontal defect involved 50-75% of the lid (3 pts.), more than 75% (3 pts.), and more than 75% plus the lateral canthus (2 pts.). The posterior lamella was reconstructed with contralateral upper eyelid tarsal plate. The anterior lamella was reconstructed with a laterally based myocutaneous pedicle flap in 7 @entity1 , leaving a raw surface under the brow which was covered with a free skin graft. In 1 @entity1 with little skin left under the brow, the anterior lamella was reconstructed with a bi-pedicle orbicularis muscle flap together with a free skin graft. RESULTS: All @entity1 healed without @entity39 , did not suffer from lagophthalmos, achieved reasonable cosmesis, and did not need lubricants. In one @entity1 , a contact lens was necessary for three weeks because of @entity2687 . One @entity1 still needs a contact lens 3 months after excision to avoid eye discomfort. CONCLUSION: Large upper @entity3066 can be reconstructed with a free tarsal plate graft and a laterally based myocutaneous pedicle flap in combination with a free skin graft. Two-step procedures can probably be avoided in most cases.
