By Gerald J. Harris MD FACS
This full-color atlas is a pragmatic, step by step consultant to the reconstruction of periocular defects following tumor excision or tissue-loss trauma. The ebook addresses the categorical anatomic matters in each one oculofacial area with adapted surgical rules and methods designed to enhance aesthetic outcomes.
Full-color illustrations with precise explanatory legends depict every one step of every surgical procedure. Flap layout and mobilization are proven without delay on surgical images, instead of in idealized drawings. The transparent, available writing variety will attract ophthalmic and plastic surgeons, non-ophthalmic surgeons, and non-surgical ophthalmic specialists.
A significant other site will contain a web photo bank.
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Additional resources for Atlas of Oculofacial Reconstruction: Principles and Techniques for the Repair of Periocular Defects
36). 35 A. Defect of the entire right lower eyelid and lower canaliculus, repaired with bicanalicular nasolacrimal intubation, a full-width tarsoconjunctival flap, and a skin graft from the right upper eyelid. The medial 2 mm of the transposed flap was split longitudinally and was sutured posterior and anterior to the lacrimal stent with 6-0 and 7-0 polyglactin, respectively. The flap was separated 6 weeks later. B. Patient 3 months after primary repair, with some visibility of the graft. The disadvantage of palpebral fissure occlusion can be mitigated by opening a central window in the flap.
Patient 4 months after primary repair, with a slightly irregular and erythematous eyelid margin. 37 In cases with sufficiently lax and supple lower eyelid skin, the classic Hughes procedure can be modified with a horizontally directed skin flap as the anterior lamella replacement (see Fig. 38). 38 In my experience, the combination of flaps results in a more natural eyelid margin. Although the time of flap separation is not dictated by vascularization of an overlying graft, the attachment is maintained long enough to counter any downward traction observed during the early postoperative period.
59 A. A marginal defect extending to but not involving the right upper punctum. B. Reconstruction with a tarsoconjunctival flap transposed to the margin and resurfaced with a skin flap (see Fig. 60). 59. 61 A. 59. B. The patient 6 months after surgery, showing the conjunctival aspect of the reconstructed right upper eyelid (see Fig. 62). 61, 6 months after right upper eyelid reconstruction. 63 A 76-year-old man referred with a right upper eyelid lesion of 6 months' duration. Biopsy revealed Merkel cell tumor.