In recent years new modern therapeutic concepts have been developed in the treatment of malignant eyelid tumors; however, surgical restoration remains an important component of the therapeutic options addressed, which include microsurgical tumor excision into healthy tissue and subsequent coverage of the defects. An ophthalmic surgeon experienced in oculoplastic surgery is responsible for the recognition and evaluation of the existing alterations and planning a procedure together with the patient that meets the patient's expectations. The planning of surgery must always be individualized and fit the initial findings. Depending on the defect size and localization, different coverage strategies are available to the surgeon. To ensure successful reconstruction, every surgeon should master a wide range of reconstructive techniques.

In den letzten Jahren haben sich neue, moderne Therapiekonzepte in der Behandlung von malignen Lidtumoren entwickelt. Die chirurgische Sanierung bleibt jedoch weiterhin ein wichtiger Bestandteil der Therapiemöglichkeiten, welche die mikrochirurgische Tumorexzision im gesunden Gewebe sowie die anschließende Deckung der Defekte umfassen. Ein okuloplastisch erfahrener Ophthalmochirurg ist für die Erkennung und Bewertung der vorhandenen Veränderung zuständig und sollte zusammen mit dem Patienten ein dessen Vorstellungen entsprechendes Vorgehen planen. Die Operationsplanung muss stets individuell erfolgen und passend zum Ausgangsbefund durchgeführt werden. Abhängig von der Defektgröße und Lokalisation stehen dem Operateur unterschiedliche Deckungsstrategien zur Verfügung. Um eine erfolgreiche Rekonstruktion zu gewährleisten, sollte jeder Operateur eine breite Palette rekonstruktiver Techniken beherrschen.

• Klíčová slova
• Defect coverage, Microsurgical tumor excision, Oculoplasty, Ophthalmic surgeon, Reconstructive techniques,
• MeSH
• chirurgové * MeSH
• lidé MeSH
• nádory kůže * chirurgie   MeSH
• nádory očního víčka * chirurgie   MeSH
• oftalmologie * MeSH
• zákroky plastické chirurgie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: The Cutler-Beard bridge flap technique is an established method for reconstruction of large full thickness upper eyelid defects. The purpose of the present study was to report experiences with the surgical technique, complications and results of this cutaneoconjunctival flap procedure following tumor resection. PATIENTS AND METHODS: A total of 18 patients with extensive full thickness upper eyelid defects after tumor excision underwent a Cutler-Beard procedure. Of the patients four received an additional eye bank scleral implant and one received an additional free tarsal graft from the fellow upper eyelid to enhance eyelid stability. RESULTS: The Cutler-Beard bridge flap technique was surgically feasible in all patients without causing damage to the lower eyelid bridge or resulting in any infections. Out of the 13 reconstructions without additional stabilizing tissue 3 (23%) developed an upper eyelid entropion that was successfully managed using a secondary scleral implant. None of the five reconstructions using additional scleral or tarsal tissue showed an entropion of the upper eyelid. CONCLUSION: The Cutler-Beard bridge flap technique, which can be combined with grafting additional stabilization tissue in defects exceeding 75% of the upper eyelid length, is a reliable method for reconstruction of large full thickness upper eyelid defects following tumor excision.

• Klíčová slova
• Basal cell carcinoma, Blepharoplasty, Eyelid neoplasms, Ophthalmic plastic surgery, Transplantation,
• MeSH
• blefaroplastika metody   MeSH
• chirurgické laloky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory očního víčka patologie   chirurgie   MeSH
• oční víčka patologie   chirurgie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH