Upper Eyelid Reconstruction Workup

Author: Maurice M Khosh, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA more...

Updated: Jun 30, 2010

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Laboratory Studies
Imaging Studies
Other Tests
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Laboratory Studies

Standard preoperative testing of cardiopulmonary function and blood parameters is necessary to avoid increased risk associated with a surgical procedure.

Imaging Studies

Imaging studies such as CT scan or MRI may be necessary to plan surgical excision of a tumor. They also may aid in predicting the extent of the defect and the availability of adjacent tissues for reconstruction.

Other Tests

Prior to surgical reconstruction of the upper eyelid, an evaluation by an ophthalmologist is indicated to determine visual acuity, lacrimation, and extraocular movement.

Proceed to Treatment & Management

Contributor Information and Disclosures

Author

Maurice M Khosh, MD, FACS Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons; Private Practice, Head and Neck Surgical Group; Attending Surgeon, Lenox Hill Hospital, Manhattan Eye, Ear and Throat Infirmary, Columbia Presbyterian Medical Center, St Luke's-Roosevelt Hospital Center, Beth Israel Medical Center

Maurice M Khosh, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Triological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Anthony P Sclafani, MD Director of Facial Plastic Surgery and Surgeon Director, New York Eye and Ear Infirmary; Professor of Otolaryngology, New York Medical College

Anthony P Sclafani, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons

Disclosure: Contura None Board membership; Cascade Medical Enterprises, Inc. Grant/research funds Independent contractor; Cascade Medical Enterprises, Inc. None Board membership; Aesthetic Factors, Inc. Grant/research funds Independent contractor

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS Program Director and Division Chair, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

Demir Z, Yuce S, Karamursel S, Celebioglu S. Orbicularis oculi myocutaneous advancement flap for upper eyelid reconstruction. Plast Reconstr Surg. Feb 2008;121(2):443-50. [Medline].
Cöloglu H, Koçer U, Oruç M, Sahin B, Ozdemir R. Axial bilobed superficial temporal artery island flap (tulip flap): reconstruction of combined defects of the lateral canthus including the lower and upper eyelids. Plast Reconstr Surg. Jun 2007;119(7):2080-7. [Medline].
Scuderi N, Ribuffo D, Chiummariello S. Total and subtotal upper eyelid reconstruction with the nasal chondromucosal flap: a 10-year experience. Plast Reconstr Surg. Apr 15 2005;115(5):1259-65. [Medline].
Cutler NL, Beard C. A method for partial and total upper lid reconstruction. Am J Ophthalmol. Jan 1955;39(1):1-7. [Medline].
Kornish JW. Eyelid reconstruction. In: Wright KW, Tse DT, eds. Color Atlas of Ophthalmic Surgery-Occuloplastic Surgery. Philadelphia, Pa: JB Lippincott; 1992.
Mauriello JA Jr, Antonacci R. Single tarsoconjunctival flap (lower eyelid) for upper eyelid reconstruction ("reverse" modified Hughes procedure). Ophthalmic Surg. Jun 1994;25(6):374-8. [Medline].
Spinelli HM, Jelks GW. Periocular reconstruction: a systematic approach. Plast Reconstr Surg. May 1993;91(6):1017-24; discussion 1025-6. [Medline].
Tenzel RR. Orbit and occuloplastics. In: Podos SM, Yanoff M, eds. Textbook of Ophthalmology. 4^th ed. New York, NY: Gower Medical Publishing; 1993.

After release of the upper lateral canthal tendon and prior to closing the defect, the defect must be converted into a pentagonal shape by removing a triangular wedge at the top. This allows closure without a large dog-ear deformity.

The width of the flap is equal the width of the defect. The incision is made 5 mm inferior to the lash line in order to avoid damage to the tarsal plate. At the time of flap release, care should be taken to protect the globe.

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