UPPER EYELID RECONSTRUCTION SURGERIES; COMPARISON OF OUTCOMES BETWEEN REVERSE TENZEL FLAP VERSUS CUTLER BEARD FLAP PROCEDURE

Authors

  • Sabeen Abbasi Department of Ophthalmology, Layton Rahmatullah Benevolent Trust, Karachi-Pakistan
  • Zeeshan Kamil Department of Ophthalmology, Layton Rahmatullah Benevolent Trust, Karachi-Pakistan
  • Syed Muhammad Faisal • Department of Ophthalmology, Sindh institute of Ophthalmology & Visual sciences, Hyderabad-Pakistan
  • Syed Muhammad Saad Department of Ophthalmology, Layton Rahmatullah Benevolent Trust, Karachi-Pakistan
  • Tanweer Hassan Department of Ophthalmology, Layton Rahmatullah Benevolent Trust, Karachi-Pakistan

Abstract

Background: Objective of this study was to compare Reverse Tenzel flap and Cutler Beard flap for upper eyelid defects. Methods: This interventional study was carried out at occuloplasty department of LRBT (Layton Rahamatullah Benevoloent Trust), Karachi. Patients diagnosed with upper eye lid defect between 50 and 75 years were included after ethical approval from institutional ethical review committee and briefing patients about study dynamics. The patients were randomly divided in two groups, group A in whom reverse tanzel flap was done, while in group B Cutler beard procedure was done. Main outcome measure was eyelid contour, complete lid closure and surgical procedure time. SPSS version 25.0 was used for data analysis. Results: Reverse Tenzel flap mean age 64.00±6.17 years, mean duration of surgery 33±5.78 minutes, and mean healing time 2.2±0.41 weeks. Cutler Beard flap mean age 59.60±6.26 years, mean duration of surgery 32±5.78 minutes, and mean healing time 5.7±0.8 in 3 weeks. 60% of patients were female. 30 (50%) patients each underwent Reverse Tenzel flap and Cutler Beard flap. In Reverse Tenzel flap, no complications were observed. In Cutler Beard flap, 06 (20%) patients reported mild entropion, 04 (13.3%) retraction of flap and 02 (6.7%) were found to have mild incomplete lid closure. Conclusion: Reverse Tenzel flap was superior to Cutler Beard flap as it reported no complications, being single stage surgery with early healing. Cutler-Beard flap reported mild entropion and retraction of flaps which required second surgery and delayed healing.

References

Anlatici R, Ozerdem OR. Reconstruction of eyelids and related structures. J Craniofac Surg 2016;27(5):484–7.

Sand JP, Zhu BZ, Desai SC. Surgical anatomy of the eyelids. Facial Plast Surg Clin North Am 2016;24(2):89–95.

Kels BD, Grzybowski A, Grant-Kels JM. Human ocular anatomy. Clin Dermatol 2015;33(2):140–6.

Chang EI, Esmaeli B, Butler CE. Eyelid reconstruction. Plast Reconstr Surg 2017;140(5):724–35.

Codner MA, McCord CD, Mejia JD, Lalonde D. Upper and lower eyelid reconstruction. Plast Reconstr Surg 2010;126(5):231–45.

Ovadia S, Alabiad C. Tenzel Semicircular Flap. In: Operative Dictations in Plastic and Reconstructive Surgery. Springer, 2017; p.293–5.

Crane A, Erickson B, Lee WW. Tenzel Semicircular Flap. In: Rosenberg ED, Nattis AS, Nattis RJ, editors. Operative Dictations in Ophthalmology, Springer. 2017; p.573–5.

Sharma PR, Ikram MS, Dickson MG. Case report: the use of a modified Tenzel-type flap to reconstruct two separate peri-ocular defects. Eur J Plast Surg 2012;35(2):189–91.

Kopecky A, Koch KR, Bucher F, Cursiefen C, Heindl LM. Results of Cutler-Beard procedure for reconstruction of extensive full thickness upper eyelid defects following tumor resection. Ophthalmologe 2016;113(4):309–13.

Belmajdoub M, Jacomet PV, Benillouche P, Galatoire O. Upper eyelid reconstruction with the Cutler-Beard flap technique: Restrospective study of 16 cases. J Fr Ophtalmol 2015;38(7):607–14.

Lisman RD, Zoumalan CI. Composite advancement flap (Cutler-Beard procedure). Man Oculoplastic Surg 2018;2018:381–7.

Mathijssen IM, van der Meulen JC. Guidelines for reconstruction of the eyelids and canthal regions. J Plast Reconstr Aesthet Surg 2010;63(9):1420–33.

Saito A, Saito N, Furukawa H, Hayashi T, Oyama A, Funayama E, et al. Reconstruction of periorbital defects following malignant tumour excision: a report of 50 cases. J Plast Reconstr Aesthet Surg 2012;65(5):665–70.

Pe’er J. Pathology of eyelid tumors. Indian J Ophthalmol 2016;64(3):177–90.

Poh EW, O'Donnell BA, McNab AA, Sullivan TJ, Gaskin B, Malhotra R, et al. Outcomes of upper eyelid reconstruction. Ophthalmology 2014;121(2):612–3.

Alghoul M, Pacella SJ, McClellan WT, Codner MA. Eyelid reconstruction. Plast Reconstr Surg 2013;132(2):e288–302.

Cook Jr BE, Bartley GB. Treatment options and future prospects for the management of eyelid malignancies: an evidence-based update. Ophthalmology 2001;108(11):2088–98.

Rafii AA, Enepekides DJ. Upper and lower eyelid reconstruction: the year in review. Curr Opin Otolaryngol Head Neck Surg 2006;14(4):227–33.

Jewett BS, Shockley WW. Reconstructive options for periocular defects. Otolaryngol Clin North Am 2001;34(3):601–25.

Tenzel RR. Reconstruction of the central one half of an eyelid. Arch Ophthalmol 1975;93(2):125–6.

Tenzel RR, Stewart WB. Eyelid reconstruction by the semicircle flap technique. Ophthalmology 1978;85(11):1164–9.

DiFrancesco LM, Codner MA, McCord CD. Upper eyelid reconstruction. Plast Reconstr Surg 2004;114(7):98–107.

Rahmi D, Mehmet B, Ceyda B, Sibel Ö. Management of the large upper eyelid defects with cutler-beard flap. J Ophthalmol 2014;2014:424567.

Downloads

Published

2021-12-31