COMBINED THREE OPERATIONS FOR ONE STAGE DEFECTS REPAIR AFTER RESECTION OF LARGE XANTHELASMA PALPEBRARUM WITH EPICANTHUS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZENGLinghuan ¹ ,  CHENJunjie ² ,  CENYing ² , LEILei ¹ , QINXiaohui ¹ , WANGYa ¹ , ZENGChuanxiu ¹

1. Department of Plastic Surgery, Sichuan Integrative Medicine Hospital, Chengdu Sichuan, 610041, P. R. China;
2. Department of Burn and Plastic Surgery, West China Hospital, Sichuan University;

Corresponding?author：

CHENJunjie, Email: cjjemail@163.com; CENYing, Email: cenying0141@163.com

Keywords：

Xanthelasma palpebrarum; Rotated total upper eyelid skin flap; Construction of double eyelid; Epicanthal plasty

DOI：

10.7507/1002-1892.20160230

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Objective To investigate the effectiveness of combined three operations (rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty) for one stage defect repair after resection of xanthelasma palpebrarum with epicanthus. Methods Between December 2013 and December 2015, 12 female patients with large xanthelasma palpebrarum and epicanthus underwent rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty for one stage defect repair. The age ranged from 36 to 59 years (mean, 43 years). The course of disease was 3 to 16 years, with an average of 11 years. The initial resection was performed in 6 cases, second resection of residual xanthelasma palpebrarum in 4 cases, and 2 cases had recurrence after resection. The maximum diameter of xanthelasma palpebrarum was 0.5-1.3 cm (mean, 1.0 cm). According to CHE Junmin et al criterion, epicanthus was rated as mild in 7 cases, moderate in 3 cases, and severe in 2 cases. The blood lipid level was in normal range. Results Primary healing of incision was obtained, and the flaps survived in all patients; no complication occurred. Scar hyperplasia was found in 4 cases at 1 month after operation, and the comprehensive treatment of scar was performed. All patients were followed up for 3 months to 2 years, with an average of 1.5 years. Double eyelid effects were good, and no xanthelasma palpebrarum recurred. Conclusion A combination of rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty is an effective operative procedure to repair defect after resection of xanthelasma palpebrarum with epicanthus; and better curve of double eyelid, better shape of endocanthion, and less tension of flap can be got.

Citation： ZENGLinghuan, CHENJunjie, CENYing, LEILei, QINXiaohui, WANGYa, ZENGChuanxiu. COMBINED THREE OPERATIONS FOR ONE STAGE DEFECTS REPAIR AFTER RESECTION OF LARGE XANTHELASMA PALPEBRARUM WITH EPICANTHUS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(9): 1130-1133. doi: 10.7507/1002-1892.20160230 Copy

1.	?Yang Y, Sun J, Xiong L, et al. Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty. Aesthetic Plast Surg, 2013, 37(5):882-886.
2.	羅東升, 潘寧, 熊俊浩, 等.瞼黃瘤切除聯合上瞼松弛成形術的臨床研究.四川醫學, 2011, 32(11):1700-1702.
3.	鄭濤, 邵英, 林泉, 等. "Ω"形皮瓣法聯合上瞼皮膚松弛矯正術在老年人瞼黃瘤切除后缺損修復中的應用.中國老年學雜志, 2014, 34(8):2144-2146.
4.	李棟梁, 李慶霞, 冉亮, 等.全上瞼皮瓣在瞼黃瘤切除創面修復中的應用.中國美容醫學, 2002, 11(3):265.
5.	車俊敏, 程輝龍. 2680名大中學生內眥贅皮的調查.中國臨床解剖學雜志, 2000, 18(4):390.
6.	朱光輝, 張樹青, 高培培. Z成形術矯正內眥贅皮的效果觀察.中國美容醫學, 2016, 25(4):7-9.
7.	Wang S, Shi F, Luo X, et al. Epicanthal fold correction:our experience and comparison among three kinds of epicanthopalsties. J Plast Reconstr Aesthet Surg, 2013, 66(5):682-687.
8.	韓芷敏, 曹國平, 董莉莉.眼瞼黃色瘤的手術治療體會.中國美容醫學, 2011, 20(1):42.
9.	Beergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol, 1994, 30(2 Pt 1):236-242.
10.	湯恭鋒.超脈沖CO₂激光與液氮冷凍治療瞼黃瘤的療效比較及分析.中國美容醫學, 2015, 24(22):46-48.
11.	Wang H, Shi Y, Guan H, et al. Treatment of xanthelasma palpebrarum with intralesional pingyangmycin. Dermatol Surg, 2016, 42(3):368-376.
12.	李鳳鳴.中華眼科學. 2版.北京:人民衛生出版社, 2005:886.
13.	DoiH, Ogawa Y. A new operative method for treatment of xanthelasma or xanthelasma palpebrarum:microsurgical inverted peeling. Plast Reconstr Surg, 1998, 102(4):1171-1174.
14.	Kose R. Treatment of large xanthelasma palpebrarums with full-thickness skin grafts obtained by blepharoplasty. J Cutan Med Surg, 2013, 17(3):197-200.
15.	Uemura T, Yanai T, Yasuta M, et al. Switch flap for upper eyelid reconstruction-how soom should the flap be divided? Plast Reconstr Surg Glob Open, 2016, 4(4):e695.
16.	Kesiktas E, Eser C, Gencel E, et al. A useful flap combination in wide and complex defect reconstruction of the medial canthal region:Glabellarrotation and nasolabial V-Y advancement flaps. Plast Srug (Oakv), 2015, 23(2):113-115.
17.	戴海英, 楊超, 張敬德, 等.眼瞼局部皮瓣在修復瞼緣色素痣切除后創面中的應用.中國美容醫學, 2010, 19(11):1612-1614.
18.	李旭東, 趙燁德, 周強, 等. A-T皮瓣在面部皮膚缺損修復中的應用.中國美容醫學, 2014, 23(23):1957-1958.

1. ?Yang Y, Sun J, Xiong L, et al. Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty. Aesthetic Plast Surg, 2013, 37(5):882-886.
2. 羅東升, 潘寧, 熊俊浩, 等.瞼黃瘤切除聯合上瞼松弛成形術的臨床研究.四川醫學, 2011, 32(11):1700-1702.
3. 鄭濤, 邵英, 林泉, 等. "Ω"形皮瓣法聯合上瞼皮膚松弛矯正術在老年人瞼黃瘤切除后缺損修復中的應用.中國老年學雜志, 2014, 34(8):2144-2146.
4. 李棟梁, 李慶霞, 冉亮, 等.全上瞼皮瓣在瞼黃瘤切除創面修復中的應用.中國美容醫學, 2002, 11(3):265.
5. 車俊敏, 程輝龍. 2680名大中學生內眥贅皮的調查.中國臨床解剖學雜志, 2000, 18(4):390.
6. 朱光輝, 張樹青, 高培培. Z成形術矯正內眥贅皮的效果觀察.中國美容醫學, 2016, 25(4):7-9.
7. Wang S, Shi F, Luo X, et al. Epicanthal fold correction:our experience and comparison among three kinds of epicanthopalsties. J Plast Reconstr Aesthet Surg, 2013, 66(5):682-687.
8. 韓芷敏, 曹國平, 董莉莉.眼瞼黃色瘤的手術治療體會.中國美容醫學, 2011, 20(1):42.
9. Beergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol, 1994, 30(2 Pt 1):236-242.
10. 湯恭鋒.超脈沖CO₂激光與液氮冷凍治療瞼黃瘤的療效比較及分析.中國美容醫學, 2015, 24(22):46-48.
11. Wang H, Shi Y, Guan H, et al. Treatment of xanthelasma palpebrarum with intralesional pingyangmycin. Dermatol Surg, 2016, 42(3):368-376.
12. 李鳳鳴.中華眼科學. 2版.北京:人民衛生出版社, 2005:886.
13. DoiH, Ogawa Y. A new operative method for treatment of xanthelasma or xanthelasma palpebrarum:microsurgical inverted peeling. Plast Reconstr Surg, 1998, 102(4):1171-1174.
14. Kose R. Treatment of large xanthelasma palpebrarums with full-thickness skin grafts obtained by blepharoplasty. J Cutan Med Surg, 2013, 17(3):197-200.
15. Uemura T, Yanai T, Yasuta M, et al. Switch flap for upper eyelid reconstruction-how soom should the flap be divided? Plast Reconstr Surg Glob Open, 2016, 4(4):e695.
16. Kesiktas E, Eser C, Gencel E, et al. A useful flap combination in wide and complex defect reconstruction of the medial canthal region:Glabellarrotation and nasolabial V-Y advancement flaps. Plast Srug (Oakv), 2015, 23(2):113-115.
17. 戴海英, 楊超, 張敬德, 等.眼瞼局部皮瓣在修復瞼緣色素痣切除后創面中的應用.中國美容醫學, 2010, 19(11):1612-1614.
18. 李旭東, 趙燁德, 周強, 等. A-T皮瓣在面部皮膚缺損修復中的應用.中國美容醫學, 2014, 23(23):1957-1958.

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Chinese Journal of Reparative and Reconstructive Surgery

COMBINED THREE OPERATIONS FOR ONE STAGE DEFECTS REPAIR AFTER RESECTION OF LARGE XANTHELASMA PALPEBRARUM WITH EPICANTHUS

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