眼睑缺损的重建手术,来自Ophthal

眼睑缺损的重建手术，来自《OphthalmicOncology》，胡健年1月译，著作权/版权归原作者/出版社所有。

译者注：不可无书，不可全书。

Chapter18ReconstructiveSurgeryforEyelidDefects

第十八章眼睑缺损的重建手术

AbstractWithadepletingozonelayerandincreasingultravioletradiationexposure,theincidenceofeyelidcancersisontherise,andwecanexpectagrowingneedforeyelidreconstruction.Severalreconstructivetechniquesmaybeappropriateforaparticulareyeliddefect.Thechoiceofprocedurebythesurgeondependsonthepatient’sage,thedegreeofeyelidlaxityandqualityofeyelidskin,thelocationandsizeofthedefect,andthesurgeon’spreference.Regardlessofthesurgicalprocedurechosen,thegoalsoftheprocedureshouldberestorationofboththeanatomyandthedynamicfunctionoftheeyelid,creationofastableeyelidmargin,acceptableverticaleyelidheight,adequateeyelidclosure,smoothposteriorepithelialsurface,andmaximumcosmesisandsymmetry.摘要：随着臭氧层逐渐变薄和紫外线暴露增加，眼睑癌发生率升高，可以预料需要眼睑重建的病例会增多。对某一具体的眼睑缺损，可能有多种重建术式是适宜的。术者选择术式取决于患者年龄、眼睑松弛程度和眼睑皮肤治疗、缺损位置和大小、术者的偏好。无论选择各种术式，目标是恢复眼睑的解剖和动态功能、创建稳定的睑缘、可接受的眼睑垂直高度、足够的眼睑闭合、平滑的眼睑后表面、最大程度的美观和对称。

18.1Introduction导言

Withadepletingozonelayerandincreasingultravioletradiationexposure,theincidenceofeyelidcancersisontherise,andwecanexpectagrowingneedforeyelidreconstruction.Thefollowingchapterdetailseyelidreconstructionfollowingtumorresection.随着臭氧层逐渐变薄和紫外线暴露增加，眼睑癌发生率升高，可以预料需要眼睑重建的病例会增多。本章是肿瘤切除后眼睑重建的内容。

18.2GeneralPrinciples一般原则

Regardlessofthesurgicalprocedurechosen,thegoalsoftheprocedureshouldberestorationofboththeanatomyandthedynamicfunctionoftheeyelid,creationofastableeyelidmargin,acceptableverticaleyelidheight,adequateeyelidclosure,smoothposteriorepithelialsurface,andmaximumcosmesisandsymmetry.Thereconstructivetechniquechosenforeyeliddefectslargelydependsontheextentoffull-thicknesshorizontallidresection.Thesurgeonmaybesurprisedatthefinalsizeofaliddefectfollowingtumorexcisioniffrozen-sectionhistopathologicexaminationprovesthetumortobemoreextensivethanclinicallyestimated.Therefore,thepatientshouldbecounseledaboutthepotentialextentoftheeyeliddefectbasedontheanatomiclocationandtypeofcancer.无论选择各种术式，目标是恢复眼睑的解剖和动态功能、创建稳定的睑缘、可接受的眼睑垂直高度、充分的眼睑闭合、平滑的眼睑后表面、最大程度的美观和对称。眼睑缺损重建技术的选择主要取决于眼睑水平全层切除的程度。若术中冰冻病理检查结果证实肿瘤比临床估计的更大，术者可能会惊讶于切除后眼睑缺损的程度。因此，术前应告知患者所预计的眼睑缺损可能的范围（基于解剖位置和恶性肿瘤类型）。

Forthepurposesofrepair,theeyelidscanbethoughtofasbeingmadeofananteriorandaposteriorlamella.Theanteriorlamellaconsistsoftheskinandorbicularismuscle,whiletheposteriorlamellaismadeupofthetarsusandconjunctiva.Itisimportanttoreconstructboththeanteriorandposteriorlamellae.Reconstructionofeithertheanteriorortheposteriorlamellamaybeac

转载请注明：http://www.mqkpm.com/bzzs/10646.html