By Gerald J. Harris MD FACS
This full-color atlas is a realistic, step by step consultant to the reconstruction of periocular defects following tumor excision or tissue-loss trauma. The booklet addresses the explicit anatomic issues in each one oculofacial quarter with adapted surgical ideas and methods designed to enhance aesthetic outcomes.
Full-color illustrations with certain explanatory legends depict every one step of every surgical strategy. Flap layout and mobilization are proven at once on surgical images, instead of in idealized drawings. The transparent, available writing variety will entice ophthalmic and plastic surgeons, non-ophthalmic surgeons, and non-surgical ophthalmic specialists.
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Additional resources for Atlas of Oculofacial Reconstruction: Principles and Techniques for the Repair of Periocular Defects
A broad defect, including the lower limb of the lateral canthal tendon. C. The tarsoconjunctival flap has been transposed and sutured to residual tarsus medially and to internal periosteum laterally. D. Using a relaxed skin tension line incision, a lower eyelid/cheek flap has been raised. E, F. A retractor protects the orbital septum from a 4-0 polyglactin 910 suture to be passed through periosteum external to the orbital rim (asterisk), which will anchor the cheek flap. 41 Combined Hughes and anchored cheek flaps.
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. A, B. Mohs resection included the central half of the tarsus, to within 2 to 3 mm of its upper border. C. Reconstruction involved a reverse Hughes flap from the lower eyelid and a free tarsal graft from the left (contralateral) upper eyelid (see Fig.
Separation can also be accelerated to 2 to 3 weeks after primary repair, but longer attachment helps to counter downward traction as the wound bed fibroses. 36 A. Defect involving the entire right lower eyelid, lateral canthus, and inferior canaliculus. Tissue loss extended posteriorly to the lower edge of the bulbar conjunctiva and anteriorly to the skin overlying the inferior orbital rim, with baring of orbital fat. Reconstruction included lacrimal intubation and a full-width Hughes flap covered with skin grafts from both upper eyelids.