Correction of Lower Eyelid Retraction with Autogenous Hard Palate Mucosa: 2 Case Report

자가 경구개점막 이식을 이용한 하안검 퇴축의 교정: 2례 보고

  • Kim, Jino (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Seul, Chul Hwan (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Roh, Tae Suk (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Yoo, Woon Min (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine)
  • 김진오 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 설철환 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 노태석 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 유원민 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실)
  • Received : 2006.01.06
  • Published : 2006.07.10

Abstract

Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.

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