Clinical use of a new axial chondro-mucosal flap in wide full-thickness eyelid reconstructions

BACKGROUND AND OBJECTIVE: Full thickness reconstruction of more than half o f an eyelid, mainly of the upper one, is a challenge for the surgeon. In 19 92, for the first time, the authors reported the use of an axial chondro-mu cosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 18 patients operated on using the above te chnique during the period June 1991-March 1997. PATIENTS AND METHODS: Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, leng th of the palpebral rim, rim opening, levator function, an aesthetic balanc e of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months. RESULTS: The axial chondro-mucosal flap was clinically viable in all patien ts. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm, levator funct ion (mean 13 mm) was shown. CONCLUSION: The authors discuss their complications and results and feel th at this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstr uction, for wide defects when the use of other flaps is compromised.