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Total Upper Eyelid Reconstruction with Modified Cutler-Beard Procedure Using Autogenous Auricular Cartilage
Salil Kumar Mandal1, James Christian Fleming2, Shilpa Gillella Reddy3
1Associate Professor, Department of Ophthalmology, Regional Institute of Ophthalmology, Medical College and Hospital , Kolkata, India .
Journal of Clinical and Diagnostic Research : JCDR
|September 23, 2016
Summary
The modified Cutler-Beard procedure effectively reconstructs large upper eyelid defects using ear cartilage. This two-stage surgery offers excellent anatomical, functional, and cosmetic outcomes, making it a valuable option, especially in resource-limited settings.
Area of Science:
- Oculoplastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Malignant upper eyelid tumors present significant surgical challenges.
- Large full-thickness eyelid defects require prompt and effective reconstruction.
- The modified Cutler-Beard procedure offers a solution for extensive upper eyelid loss.
Purpose of the Study:
- To assess the efficacy of the modified Cutler-Beard procedure using autogenous auricular cartilage.
- To evaluate its use in reconstructing 70-100% upper eyelid defects.
- To determine functional and cosmetic outcomes in patients undergoing this procedure.
Main Methods:
- A prospective, interventional case series involving 16 patients over three years.
- Inclusion criteria: 70-100% upper eyelid defects post-tumor removal.
- Exclusion criteria: lymph node involvement, metastasis, lower eyelid/orbital invasion.
Main Results:
- Successful upper eyelid reconstruction in all 16 patients.
- Significant improvement in Levator Palpebrae Superioris (LPS) action (0-4 mm to 12-14 mm).
- Restoration of Margin to Reflex Distance (MRD1) from negative to positive values (+3 to +4 mm).
Conclusions:
- The modified Cutler-Beard procedure with auricular cartilage is effective for large upper eyelid defects.
- Achieves acceptable functional and cosmetic results.
- A cost-effective and valuable option, particularly in resource-poor settings.
