Reconstruction of Full-Thickness Lower Lid Defects Using Texier's Procedure: Retrospective Assessment of the Indications.

Abstract

PURPOSE:

Lower lid defects involving more than 75% of the lid's length or affecting the cheek are usually reconstructed with a Mustardé rotational cheek flap. This solution often induces postoperative ectropion. The Texier procedure (an upper lid myocutaneous flap and a chondromucosal alar graft) is usually indicated for 1-step reconstruction of full-thickness defects involving less than 50% of the lower lid. This retrospective study evaluated larger indications for the Texier procedure for full-thickness defects of the lower lid, results of lid defects longer than 50 or even 75%, and the use of a chondromucosal nasal septal graft for lid defects longer than 75%.

MATERIALS AND METHODS:

All lower lid reconstructions using the Texier procedure over a period of 29 months were retrospectively included. Data on postoperative complications and patient satisfaction were collected.

RESULTS:

Fifteen patients were included; one third had a defect involving no more than 50% of the lower lid, one third presented with a defect of 50 to 75%, and one third had a defect of at least 75%. In this last group, reconstruction included a septal graft. Mean follow-up was 35 months. Transitory palpebral edema was present in 100% of patients and lasted 8 months on average. No postoperative ectropion or nasal alar retraction of the graft donor site was observed. Mean satisfaction score was 2.86 of 3.

CONCLUSIONS:

The Texier procedure can be used as first-line treatment to reconstruct most full-thickness defects of the lower lid, including subtotal defects.

• Authors: Sarra Cristofari, Kessara Rem, Marc Revol, Michael Atlan, Alessio Stivala
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 77 Issue 2 Pg. 433-439 (Feb 2019) ISSN: 1531-5053 [Electronic] United States
• PMID: 30321516 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Cheek
• Eyelid Neoplasms
• Eyelids
• Humans
• Plastic Surgery Procedures
• Retrospective Studies
• Treatment Outcome