Clinical application of modified kite flap in treatment of divided nevus of lateral canthus_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHENG Shuwen ,  WEN Huicai , HUANG Jinjun , FU Jianhua , LU Yingjie , LIAO Huaiwei , TU Jun

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China;

Corresponding?author：

WEN Huicai, Email: whcjxmc@163.com

Keywords：

Divided nevus of lateral canthus; modified kite flap; lateral canthus reconstruction; cosmetic repair

DOI：

10.7507/1002-1892.201905012

Video：

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Objective To investigate the effectiveness of modified kite flap in repair of soft tissue defect after divided nevus of lateral canthus excision.Methods Between October 2010 and April 2018, 20 children (20 eyes) with divided nevus of lateral canthus were admitted. There were 13 boys and 7 girls, with an average age of 7.9 years (mean, 4-14 years). There were 11 cases of moderate range lesions (maximum diameter, 1.5-2.0 cm) and 9 cases of small range lesions (maximum diameter, <1.5 cm). After excising the divided nevus of lateral canthus, the area of soft tissue defect ranged from 0.72 to 3.23 cm². The modified kite flap was used to reconstruct the structure and shape of lateral canthus.Results There were 16 cases of mixed nevus and 4 cases of intradermal nevus. The flaps survived and the incisions healed by the first intention. The patients were followed up 12-22 months (mean, 13.6 months). There was no malformation, valgus, exposure keratitis, or obvious scar. No malignant transformation occurred or nevus recurred during follow-up. At last follow-up, the effectiveness was rated as excellent in 16 cases, good in 3 cases, and poor in 1 case.Conclusion The modified kite flap can repair the soft tissue defect after excising the divided nevus of lateral canthus, and obtain the good appearance and function of lateral canthus.

Citation： SHENG Shuwen, WEN Huicai, HUANG Jinjun, FU Jianhua, LU Yingjie, LIAO Huaiwei, TU Jun. Clinical application of modified kite flap in treatment of divided nevus of lateral canthus. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(12): 1556-1559. doi: 10.7507/1002-1892.201905012 Copy

1.	Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol, 2005, 52(2): 197-203.
2.	Desai SC, Walen S, Holds JB, et al. Divided nevus of the eyelid: review of embryology, pathology and treatment. Am J Otolaryngol, 2013, 34(3): 223-229.
3.	Bhattacharjee K, Singh M, Bhattacharjee H. Amniotic membrane graft to reconstruct divided nevi of eyelids. BMJ Case Rep, 2015. doi: 10.1136/bcr-2014-209020.
4.	Jia R, Zhu H, Lin M, et al. Clinicopathological characteristics and surgical outcomes of divided nevus of the eyelids: a decade’s experience on 73 cases. Ann Plast Surg, 2012, 68(2): 166-170.
5.	張鮮英, 劉毅, 張誠, 等. 眼瞼不同部位分裂痣的修復方法. 中國美容整形外科雜志, 2017, 28(7): 433-435.
6.	張辰晨, 鄧遠, 李政康. 改良切口聯合局部滑行肌皮瓣一期修復中小范圍眼瞼分裂痣. 中國美容醫學, 2018, 27(4): 22-24.
7.	Ke Y, Ren X, Zhu L, et al. Primary orbital melanoma combined with giant divided nevus of the eyelid. J Craniofac Surg, 2014, 25(1): e4-e7.
8.	Watt AJ, Kotsis SV, Chung KC. Risk of melanoma arising in large congenital melanocytic nevi: a systematic review. Plast Reconstr Surg, 2004, 113(7): 1968-1974.
9.	王曉軍, 朱琳, 劉志飛, 等. 島狀皮瓣一期修復眼瞼分裂痣的設計與技巧. 中華整形外科雜志, 2010, 26(1): 15-17.
10.	Chang EI, Esmaeli B, Butler CE. Reply: The value of secondary intention healing in eyelid reconstruction: response to recent CME article by Chang, Esmaeli, and Butler—Content needs to be evidence-based. Plast Reconstr Surg, 2018. doi: 10.1097/PRS.0000000000004305.
11.	聶晶晶, 鄭春梅, 董雪, 等. 眼瞼分裂痣切除后的美容修復. 中華醫學美學美容雜志, 2018, 24(2): 136-137.
12.	陳健, 李暐. 帶蒂組織瓣在頭頸部腫瘤術后缺損修復重建中的應用研究進展. 中國修復重建外科雜志, 2018, 32(3): 369-376.
13.	李秀琪, 王太玲, 李無言, 等. 眼瞼分裂痣的手術方法選擇. 中華整形外科雜志, 2015, 31(2): 96-99.
14.	Singh M, Gautam N, Kaur M, et al. Role of amniotic membrane and full-thickness skin graft in reconstruction of kissing nevus of eyelids. Indian J Ophthalmol, 2017, 65(11): 1219-1221.
15.	倪曉靜, 王坤. " 風箏”皮瓣修復面部皮膚缺損的臨床應用. 中國美容醫學, 2018, 27(4): 27-29.
16.	Choi J, Lee Y. Bipedicled skin flap in the treatment of divided nevus of the eyelid. Dermatol Surg, 2014, 40(1): 62-65.
17.	Hu L, Jin Y, Tremp M, et al. Reconstruction of a large divided nevus of the eyelid. Dermatol Surg, 2017, 43(12): 1483-1486.
18.	文輝才, 萬珺, 眭云鵬, 等. 肌皮瓣法重瞼術的臨床療效分析. 中國修復重建外科雜志, 2017, 31(3): 327-330.
19.	劉龍燦, 劉元波, 臧夢青, 等. 以顳淺血管頂支為蒂的擴張頭皮島狀瓣再造鬢角的臨床研究. 中國修復重建外科雜志, 2017, 31(11): 1358-1362.

1. Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol, 2005, 52(2): 197-203.
2. Desai SC, Walen S, Holds JB, et al. Divided nevus of the eyelid: review of embryology, pathology and treatment. Am J Otolaryngol, 2013, 34(3): 223-229.
3. Bhattacharjee K, Singh M, Bhattacharjee H. Amniotic membrane graft to reconstruct divided nevi of eyelids. BMJ Case Rep, 2015. doi: 10.1136/bcr-2014-209020.
4. Jia R, Zhu H, Lin M, et al. Clinicopathological characteristics and surgical outcomes of divided nevus of the eyelids: a decade’s experience on 73 cases. Ann Plast Surg, 2012, 68(2): 166-170.
5. 張鮮英, 劉毅, 張誠, 等. 眼瞼不同部位分裂痣的修復方法. 中國美容整形外科雜志, 2017, 28(7): 433-435.
6. 張辰晨, 鄧遠, 李政康. 改良切口聯合局部滑行肌皮瓣一期修復中小范圍眼瞼分裂痣. 中國美容醫學, 2018, 27(4): 22-24.
7. Ke Y, Ren X, Zhu L, et al. Primary orbital melanoma combined with giant divided nevus of the eyelid. J Craniofac Surg, 2014, 25(1): e4-e7.
8. Watt AJ, Kotsis SV, Chung KC. Risk of melanoma arising in large congenital melanocytic nevi: a systematic review. Plast Reconstr Surg, 2004, 113(7): 1968-1974.
9. 王曉軍, 朱琳, 劉志飛, 等. 島狀皮瓣一期修復眼瞼分裂痣的設計與技巧. 中華整形外科雜志, 2010, 26(1): 15-17.
10. Chang EI, Esmaeli B, Butler CE. Reply: The value of secondary intention healing in eyelid reconstruction: response to recent CME article by Chang, Esmaeli, and Butler—Content needs to be evidence-based. Plast Reconstr Surg, 2018. doi: 10.1097/PRS.0000000000004305.
11. 聶晶晶, 鄭春梅, 董雪, 等. 眼瞼分裂痣切除后的美容修復. 中華醫學美學美容雜志, 2018, 24(2): 136-137.
12. 陳健, 李暐. 帶蒂組織瓣在頭頸部腫瘤術后缺損修復重建中的應用研究進展. 中國修復重建外科雜志, 2018, 32(3): 369-376.
13. 李秀琪, 王太玲, 李無言, 等. 眼瞼分裂痣的手術方法選擇. 中華整形外科雜志, 2015, 31(2): 96-99.
14. Singh M, Gautam N, Kaur M, et al. Role of amniotic membrane and full-thickness skin graft in reconstruction of kissing nevus of eyelids. Indian J Ophthalmol, 2017, 65(11): 1219-1221.
15. 倪曉靜, 王坤. " 風箏”皮瓣修復面部皮膚缺損的臨床應用. 中國美容醫學, 2018, 27(4): 27-29.
16. Choi J, Lee Y. Bipedicled skin flap in the treatment of divided nevus of the eyelid. Dermatol Surg, 2014, 40(1): 62-65.
17. Hu L, Jin Y, Tremp M, et al. Reconstruction of a large divided nevus of the eyelid. Dermatol Surg, 2017, 43(12): 1483-1486.
18. 文輝才, 萬珺, 眭云鵬, 等. 肌皮瓣法重瞼術的臨床療效分析. 中國修復重建外科雜志, 2017, 31(3): 327-330.
19. 劉龍燦, 劉元波, 臧夢青, 等. 以顳淺血管頂支為蒂的擴張頭皮島狀瓣再造鬢角的臨床研究. 中國修復重建外科雜志, 2017, 31(11): 1358-1362.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of modified kite flap in treatment of divided nevus of lateral canthus

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