scholarly journals The Use of Fascia Lata Free Graft for Lateral Canthus Reconstruction Following Mohs Lower Lid Surgery

Surgeries ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 77-81
Author(s):  
Rafal Nowak
Keyword(s):  
Lower Eyelid ◽  
Advancement Flap ◽  
Fascia Lata ◽  
Free Graft ◽  
Periosteal Flap ◽  
Lateral Canthus ◽  
Fascia Lata Graft ◽  
Free Skin Graft ◽  
Upper Lid ◽  
Lid Surgery

We present a case of a 75-year-old patient who underwent reconstruction of the lower eyelid and lateral canthus following removal of 80% of the lower eyelid due to basal cell carcinoma. A Hughes transconjunctival eyelid-sharing flap was used to form the posterior lamella, and a free skin graft from the ipsilateral upper lid was used to recreate the anterior lamella. The lateral canthal ligament was reconstructed using a free fascia lata graft. A periosteal flap was not used due to local scarring that was the result of previous multiple lateral canthal surgeries. Skin preservation in the lateral canthal area and additional horizontal support for the lower eyelid were achieved by using a local advancement flap. This two-stage surgery produced excellent functional and cosmetic effects. Fascia lata free graft can be an alternative to the periosteal flap for reconstruction of the lateral canthal ligament when use of the lateral orbital periosteum is not feasible.

Autogenous Tensor Fascia Lata Graft Replacement of the Patellar Ligament in a Dog

1997 ◽  
Vol 10 (03) ◽  
pp. 141-145 ◽  
Author(s):  
B. A. Selcer ◽  
J. D. Smith ◽  
D. N. Aron
Keyword(s):  
Fascia Lata ◽  
Patellar Ligament ◽  
Free Graft ◽  
Graft Replacement ◽  
Tensor Fascia Lata ◽  
Postoperative Rehabilitation ◽  
Patient Morbidity ◽  
Fascia Lata Graft ◽  
Trauma Case

SummaryThis report documents a complicated trauma case in a dog that was successfully managed by substitution of a missing patellar ligament with an autogenous tensor fascia lata free graft. Important to the success of the case was the use of a careful postoperative regime of progressive controlled mobilization with the aid of the hinged transarticular external skeletal fixator. Because of the advantages provided by use of the autogenous tensor fascia lata graft and the hinged transarticular external skeletal fixator, patient morbidity was low and the end result was good.An autogenous tensor fascia lata free graft was successfully used to completely substitute for a missing patellar ligament in a dog. Postoperative rehabilitation was facilitated by the use of the hinged transarticular external skeletal fixator. The technique is described along with the results. Complete substitution of the patellar ligament with a graft has not been reported in the dog.

scholarly journals Effectiveness of the Lower Eyelid Suspension Using Fascia Lata Graft for the Treatment of Lagophthalmos due to Facial Paralysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Selam Yekta Sendul ◽  
Halil Huseyin Cagatay ◽  
Burcu Dirim ◽  
Mehmet Demir ◽  
Zeynep Acar ◽  
...  
Keyword(s):  
Facial Paralysis ◽  
Corneal Ulcer ◽  
Corneal Opacity ◽  
Lower Eyelid ◽  
Fascia Lata ◽  
Effective Technique ◽  
Corneal Epithelial ◽  
Fascia Lata Graft ◽  
Sling Surgery ◽  
The Right

Purpose. To evaluate of functional and cosmetic effectiveness of lower eyelid sling technique with fascia lata graft in patients with lagophthalmos due to facial paralysis.Material and Method. Ten patients with a mean age of55.1±19.77years who underwent lower eyelid sling surgery with a fascia lata graft between September 2011 and January 2014 were included in this prospective study. Preoperatively and postoperatively patients were evaluated in terms of corneal epithelial defects, Schirmer’s test, and tear break-up time (TBUT). Cosmetically, vertical eyelid aperture, margin reflex distances 1 and 2 (MRD1 and MRD2) and scleral show were evaluated preoperatively and postoperatively.Results. One patient had facial paralysis on the right side whereas the other 9 patients had facial paralysis on the left side. Preoperatively, 3 patients were detected with corneal ulcer, whereas 7 patients were detected with persistent corneal epithelial defects localized in the lower half of the cornea. In the 3 patients with preoperative corneal ulcer, the ulcer recovered with corneal opacity, whereas in the 7 patients with punctate epitheliopathy, postoperative corneal transparency was obtained.Discussion. Lower eyelid sling technique with fascia lata graft is an effective technique for the repositioning of the lower eyelid and preventing the corneal complications.

scholarly journals Reconstruction of Combined Full-Thickness Defect of the Lateral Canthus and Lateral Upper and Lower Third Eyelids With an Extended Modification of the Fricke Flap, Periosteal Flap, and Conjunctival Flap

2019 ◽  
Vol 5 ◽  
pp. 2513826X1987945
Author(s):  
L. Ashley Griffin ◽  
Benjamin C. McIntyre
Keyword(s):  
Donor Site ◽  
Lower Eyelid ◽  
Temporal Region ◽  
Clinical Report ◽  
Periosteal Flap ◽  
Conjunctival Flap ◽  
Lateral Canthus ◽  
Aesthetic Appearance ◽  
Fricke Flap ◽  
Composite Defect

Introduction: The Fricke flap was originally described in 1829 as a laterally based flap from the temporal region that could be used to reconstruct potentially total lower eyelid defects. There have been a few minor modifications of this flap to allow for adjustments of the donor site scar, but none that address the sequelae of brow elevation and allow for reconstruction of a composite defect of the lateral canthus, lateral upper, and lower eyelids. We report our modification of the Fricke flap that allows for total reconstruction of these structures. Clinical Report: A 61-year-old male presented with composite defect of the lateral eyelids and canthus following resection of a basal cell carcinoma by Mohs technique. A Fricke flap was designed and modified to included elements of the above brow and below brow skin as an additional pennant flap. A “Y” shaped periosteal flap and inferior fornix conjunctival flap were also used to reconstruct the posterior lamella. Our surgical technique and follow-up are demonstrated. Discussion: Lateral eyelid and canthal reconstruction can be difficult to reconstruct with a single rotational flap from local sources. We describe our technique of modifying the Fricke flap to include an additional pennant of below brow skin that can be used to reconstruct the lateral eyelids and canthus allowing for a crisp lateral eyelid crease and acceptable donor site and aesthetic appearance. Conclusions: This is the first description of a modification of the Fricke flap that allows for total lateral eyelid and canthus reconstruction.

scholarly journals Lateral sliding flap for one-step reconstruction of medium-sized eyelid defects

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Dion Paridaens ◽  
Keyword(s):  
Operating Time ◽  
Case Series ◽  
Lower Eyelid ◽  
Advancement Flap ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Reconstruction Methods ◽  
Lateral Canthus ◽  
One Step ◽  
Fair Poor

Background/purpose: To report the results of our clinical study on the efficacy of a ‘Lateral Sliding Flap’: A one-step technique for lower or upper eyelid reconstruction. Methods: Retrospective analysis of a consecutive case series of patients treated with a ‘Lateral Sliding Flap’ following tumour removal by horizontal block excision. In this technique a (medium-sized) defect of up to 50% of the eyelid was reconstructed by disinsertion of the lateral canthus, medial advancement of the lateral (remaining) (full-thickness) eyelid and a laterally-based horizontal skin-muscle advancement flap, followed by canthal fixation. We recorded the operating time and evaluated the postoperative eyelid apposition, lid contour, complications and frequency and type of re-operation. The outcome was scored (according to four grades (excellent/good/fair/ poor) of lid apposition and contour. Results: Seven consecutive patients, all treated by one oculoplastic surgeon in one year, were included. Six were female, one was male. Five had lower eyelid defects, two had upper eyelid defects of 40-50% of the horizontal width. The average age was 67,9 years, ranging from 52 to 85 years. The mean postoperative follow-up time was 31 months, ranging from 21-43 months. The average duration of the reconstruction was 31 minutes (ranging from 25 to 38 minutes). The outcome was excellent in 3 patients, good in 3 patients and fair in one patient. (Some) lash loss may be encountered. No complications such as flap ischemia of necrosis were noted. No re-operation was required. Conclusion: The ‘Lateral Sliding Flap’ is an efficaceous, one-step technique for reconstruction of defects of up to 50% of the lower or upper eyelid. With the technique a normal eyelid margin is created at the level of the cornea for optimal visual function and comfort. Compared to Tenzel’s semicircular rotation flap, the ‘lateral sliding flap’ results in a shorter vertical scar and “Hidden” horizontal scars in the relaxed skin tension lines.

Interposition fascia lata sheet free graft and a composite V-Y advancement flap to correct functional incompetence of the oral sphincter

2012 ◽  
Vol 36 (4) ◽  
pp. 261-264 ◽  
Author(s):  
Yaron Har-Shai ◽  
Tamir Gil ◽  
Issa Mettanes ◽  
Nir Gal-Or ◽  
Aharon Amir
Keyword(s):  
Advancement Flap ◽  
Fascia Lata ◽  
Free Graft

scholarly journals Novel Application of Vasofix Cannula for Punctal and Canalicular Laceration

2019 ◽  
pp. 1-5
Author(s):  
Prabhakar Srinivasapuram Krishnacharya ◽  
Shamshiya Naaz ◽  
Raghavendar Reddy ◽  
Anuj Kumar Singhal
Keyword(s):  
Lower Eyelid ◽  
Work Place ◽  
Ocular Irritation ◽  
Ocular Movements ◽  
Lateral Canthus ◽  
Plate Fracture ◽  
Time Availability ◽  
Upper Lid

Aim: Purpose of present study is to investigate the efficacy of vasofix cannula in preserving punctum position and canalicular patency. Presentation of Case: A thirty four year old male patient presented with multiple right both eyelid injuries consisting of lower punctum, vertical and horizontal canalicular laceration, lower eyelid tear with tarsal plate fracture with pretarsal orbicularis muscle splitting, laceration near lateral canthus running for about an inch horizontally and vertical upper lid laceration near upper punctum inflicted by flying zinc sheet at work place. Examination revealed normal and intact ocular functions. Ocular movements were full with unremarkable fundoscopy. CT orbit showed no orbital fractures and intraocular foreign body. Vasofix cannula 24 Gauge inserted into lower punctum and canaliculus, and anchored to lid margin by vicryl 10-0 along with lid laceration repair under local anesthesia. Discussion: Punctal position, canalicular support and patency were maintained with no infection or extrusion. There was no epiphora or ocular irritation during 10 weeks of follow up. Conclusion: This case study describes management of monopunctal and horizontal as well vertical canalicular laceration by vasofix cannula acting as a stent. Anatomical and physiological functions restored with acceptable cosmetic appearance. Added advantage is that all time availability of cannula in all operation theatres. Although Vasofix cannula is semi flexible in nature can be used as a stent for canalicular intubation purpose.

scholarly journals Comparative study between fascia lata and temporalis fascia in myringoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez
Keyword(s):  
Tympanic Membrane ◽  
Good Alternative ◽  
Fascia Lata ◽  
The Body ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Fascia Lata Graft ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.

scholarly journals Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1425
Author(s):  
Paweł Cisek ◽  
Dariusz Kieszko ◽  
Mateusz Bilski ◽  
Radomir Dębicki ◽  
Ewelina Grywalska ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Late Complication ◽  
Target Volume ◽  
Lower Eyelid ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Lateral Canthus ◽  
Skin Cancers

Background: Eyelid tumors are rare skin cancers, the most common of which is basal cell carcinoma characterized primarily by local growth. In addition to surgery, radiotherapy is among the basic methods of treatment. External beam radiotherapy is associated with the risk of complications within ocular structures, especially the lens. In the case of interstitial brachytherapy, it is possible to administer a high dose to the clinical target volume (CTV), while reducing it in the most sensitive structures. Methods: This paper presents the results of an analysis of 28 patients treated with interstitial high dose rate (HDR) brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral canthus; and the cheek, nose and temples with the infiltration of ocular structures. The patients were treated according to two irradiation schedules: 49 Gy in 14 fractions of 3.5 Gy twice a day for 7 days of treatment, and 45 Gy in 5 Gy fractions twice a day for 5 days. The mean follow-up was 22 months (3–49 months). Results: two patients (6%) had a relapse: a local recurrence within the irradiated area in one of them, and metastases to lymph nodes in the other. The most common early complication was conjunctivitis (74%), and the most common late complication was dry eye syndrome (59%). Conclusions: Interstitial HDR brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral cants; and the cheek, nose and temples with infiltration of ocular structures is a highly effective, short and relatively low burden type of treatment.

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