Hard palate mucosal grafts in oculoplastic surgery: donor site lessons

Abstract

PurposeHard palate mucosal grafts have been used successfully in posterior lamellar reconstruction. Atypical surgical findings, techniques, and complications related to the hard palate donor site are reported herein. DesignInterventional case series. MethodsThe medical records of five patients who were cared for in an institutional practice between 1987 and 2002 were retrospectively reviewed. All patients had unusual donor site findings discovered during or after hard palate mucosal grafting for eyelid or socket reconstruction. ResultsSeven eyelid reconstructions with hard palate grafts were performed on the five patients (three male, two female), with an age range of 14 to 73 years at surgery. Patients were followed for an average of 6 years (range: 9 months to 11 years). Unusual hard palate findings during surgery or the postoperative period included hard palate and maxillary sinus malignancy, torus palatinus, and persistent donor site bleeding that provoked gastric variceal bleeding in a patient with preexisting liver disease. Atypical surgical techniques included both inadvertent and intentional harvesting of hard palate tissue over the midline palatine raphe. ConclusionHard palate grafting is a successful and commonly practiced approach to eyelid and socket reconstruction. An awareness of unusual anatomic findings or techniques associated with the hard palate donor site may improve surgical outcomes and decrease patient morbidity.