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The Guyuron retroauricular island flap for eyelid and eye socket reconstruction in children
J M López-Arcas1, M Martín, E Gómez
1Oral and Maxillofacial Surgery Department, Pediatric Craniofacial Section, University Hospital La Paz, P degrees Castellana 261, 28046 Madrid, Spain. jmloparc@yahoo.es
Insights
The Guyuron retroauricular island flap effectively reconstructs severe upper eyelid defects in children, achieving optimal eyelid closure and improving corneal exposure with minimal donor site morbidity.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Pediatric Surgery
Background:
- Complete loss of palpebral tissue in children necessitates reconstructive surgery.
- Causes include congenital malformations, tumor resection, and traumatic injuries.
- Existing techniques may have limitations in achieving functional and aesthetic outcomes.
Observation:
- The Guyuron retroauricular island flap was utilized for upper eyelid reconstruction in five pediatric cases.
- Patients presented with severe eyelid defects, including post-enucleation and upper eyelid coloboma.
- The age range of patients was from 5 days to 10 years.
Findings:
- Optimal closure of the eyelid fissure was achieved in all cases.
- Clinical improvement in corneal exposure was observed post-reconstruction.
- Average flap surface loss was 15%, with one case of 40% flap necrosis.
Implications:
- The Guyuron retroauricular island flap offers a viable solution for pediatric upper eyelid reconstruction.
- This technique provides functional restoration and an inconspicuous scar.
- It demonstrates limited morbidity at the donor site, making it suitable for young patients.
Abstract:
A complete loss of palpebral tissue can occur following a congenital malformation, tumour resection or traumatic injury. This article presents the authors' clinical experience with upper eyelid reconstruction in children using the Guyuron retroauricular island flap. Five cases of severe eyelid defects in children aged between 5 days and 10 years of age (three patients following enucleation and two presenting upper eyelid coloboma of approximately two-thirds of the upper eyelid surface) were treated using this technique. In all cases an optimal closure of the eyelid fissure was achieved and corneal exposure clinically improved. On average, 15% of the initial flap surface was lost. Only one major complication (40% flap necrosis) was reported in the postoperative period. This reconstructive technique can provide complete eyelid reconstruction leaving an inconspicuous scar and causing limited morbidity at the donor zone.