An eyelid is composed of three layers : an outer layer of skin, an inner layer of mucosa, and a semirigid tarsal plate interposed between them. Therefore, the reconstruction of an eyelid requires restoration of these elements. In reconstructing the lower eyelid the mucosa is replaced and additional support is necessary in order to overcome gravity and cicatrical contracture.
We have experienced 8 cases of lower eyelid reconstruction since June, 1984. In 6 cases lower eyelid cancer has been developed close to margin, 1 case was congenital syphilis and 1 case was post traumatic defect. The inner layer of lower eyelids was reconstructed with nasal septal mucochondral grafts in 4 cases and palatal mucosal grafts in 4 cases. For outer layer of lower eyelid we used various flaps ; cheek rotation flaps in 5 cases, cheek rotation flap and temporal flap in 1 case, and orbicularis oculi myocutaneous flaps in 2 cases.
We followed the patients comparing the palatal mucosal graft with the nasal septal mucochondral graft and concluded
I. The nasal septal mucochondral graft appeared to be more natural.
2. A tendency of the nasal septal mucochondral graft to curl towards the mucosa-covered side after thinning of the cartilage was an additional merit.
3. Both palatal mucosal graft and nasal septal mucochondral graft maintained stable margin of the lower eyelids.
4. Thick, mucoid secretion was troublesosnc in palatal graft group. Nevertheless, patients were
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