Reconstruction of full-thickness lower eyelid defect using superficial temporal artery island flap combined with auricular cartilage graft.

Abstract

Full-thickness lower eyelid defect is one of common surgical diseases, which may lead to exposure keratopathy, corneal ulceration, and blindness. The aim of this study was to investigate the effect of superficial temporal artery island flap combined with auricular cartilage graft on the repair of full-thickness lower eyelid defect.In this study, the reconstructions in 6 patients who had unilateral full-thickness lower eyelid defects due to ocular traumas or surgical resections of malignant tumors were carried out. The island flap of the frontal branch of superficial temporal artery reconstructed the outer layer and the total lower lid was supported with the plane of an auricular cartilage strip, offering a proper contour and physical strength to maintain a normal eyelid height. The follow-up time ranged from 6 to 24 months. No major complications including partial or total flap necrosis, signs of infection, venous congestion, and hematoma were seen in any of the patients, and all cases have been reconstructed well both aesthetically and functionally, showing esthetic eyelid contour, good color, and texture match.Superficial temporal artery island flap combined with auricular cartilage graft is a useful method functionally and cosmetically for the reconstructions of full-thickness lower eyelid defects because of its advantages including rich vascularity based on superficial temporal artery, wide pedicle rotational arc, which could be transferred throughout the face region, good eyelid contour with color and texture match, limited donor-site scar, and minimal postoperative morbidity.