Background: Reconstruction of the inferior medial canthal and nasal sidewall defects presents some particular problems resulting from the unique anatomy of this region such as the multiple contours and sigmoidal relaxed skin tension lines, differences in skin color and texture, and the anatomic limitations presented by the adjacent structures including lower eyelids, eyebrows, and lacrimal drainage system.
Purpose: In this study, the authors represent a new local flap as a new alternative for reconstruction of the defects of the inferior medial canthal region and nasal sidewalls.
Methods: In this technique, defect closure is achieved by using 2 cutaneous flaps designed in an unequal z-plasty manner. The first flap is used to cover the defect, whereas the second flap is used for closure of the first flap's donor site. From October 2006 to May 2010, a total of 16 patients 38 to 80 years old underwent medial canthal and nasal sidewall reconstruction by using this procedure. The defect size ranged from 2.0 to 3.2 cm in width.
Results: A tension-free defect closure was achieved in all patients. Except 1 patient who had slight pseudoepicanthus, there was no patient with distortion of the surrounding anatomic structures. During a mean follow-up period of 30 months (5 months to 3½ years), all patients were satisfied with the cosmetic and functional results. Except 1 patient who underwent reoperation for tumor recurrence, no patient required further surgery.
Conclusions: The reading man procedure was found to be a successful technique for the closure of inferior medial canthal and nasal sidewall defects. It allows tension-free closure of considerably larger defects without any additional healthy tissue excision and and/or dog ear formation. Moreover, using z-plasty principle, it avoids distortions of the surrounding mobile anatomic structures.
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http://dx.doi.org/10.1097/SCS.0b013e31822e82cc | DOI Listing |
Indian J Ophthalmol
February 2025
Department of Oculoplasty and Oncology Services (Dr. Rajendra Prasad Centre for Ophthalmic Sciences), AIIMS, New Delhi, India.
Background: Involution or aging is the most common cause of lower eyelid entropion (in-turning of eyelid margin) in the elderly population. Various pathomechanisms have been postulated for its occurrence. Aging leads to laxity of tissues and loss of muscle tone.
View Article and Find Full Text PDFAnn Plast Surg
February 2025
From the ThankYou Plastic Surgery Clinic, Seoul, Republic of Korea.
Background: The medial epicanthal fold is a common ethnic trait in East Asian faces, and there is a significant demand for its correction for cosmetic reasons. Numerous epicanthoplasty techniques have been proposed; however, visible scarring and unnatural canthal shapes have been challenges. This study aimed to introduce a simpler approach for medial epicanthoplasty to address these issues and evaluate its outcomes.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
Background: With globalization, oculoplastic surgeons must understand the intricate morphological nuances of the periocular region across ethnicities to ensure precise treatment and avoid facial disharmony or dysfunction. Direct comparisons in two-dimensional (2D)-based periocular morphology between studies can be challenging due to the limited number of parameters and complicated variations in equipment, environments, measurement personnel, and methods. Therefore, it is imperative to explore the detailed three-dimensional (3D) periocular morphological disparities between young Caucasian and Chinese populations.
View Article and Find Full Text PDFAm J Ophthalmol Case Rep
March 2025
Department of Ophthalmology, Hospital Sultan Idris Shah, Serdang, Malaysia.
Purpose: To highlight a case report of high-grade primary lacrimal sac Burkitt lymphoma in a young adult.
Observation: A 25-year-old gentleman was referred to the oculoplastic center for left eye medial canthal progressive swelling at the level below the medial canthal tendon for two months associated with tearing. He was initially treated for preseptal cellulitis but failed to respond to antibiotics.
Orbit
January 2025
Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India.
Purpose: To report the clinical features and operative findings of a series of patients with lacrimal sac mucoceles extending above the anatomic level of the medial canthal tendon (MCT).
Methods: A retrospective chart review of all patients presenting with lacrimal sac mucocele extending above the anatomic level of the MCT over a period of five years from 2019 and 2023. All patients underwent surgical management.
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