USE OF VARIOUS FLAPS IN REMOVAL OF CONGENITAL AND ACQUIRED EYELIDS DEFECTS IN CHILDREN

In the article we analyzed efficiency of various methods of surgical rehabilitation of children with congenital and acquired defects of the eyelids. The clinical group consisted of 65 patients at the age from 1 to 18 with congenital and acquired defects of the eyelids that underwent totally 101 surgical interventions. All children were divided into 3 groups depending on the method of compensation of the eyelids and periorbital tissues deficiency. Into the 1st group 10 patients with facial clefts and pronounced deformation of the eyelids were included; they were operated with use of modified wide bucco-zygomatic skin graft unilaterally or bilaterally. The 2nd group made 17 children with coloboma of the eyelids or extensive scarry deformation of the eyelids and periorbital area with soft tissues deficiency that was replaced by rotation flap from the forehead. Into the 3rd group were united 38 children that had scarry deformation with local skin deficiency on one or both eyelids, or ectropion eliminated by autotransplantation of the free skin flap taken from the interior surface of the auricle. In all three groups clinical and CT-signatures were described in details as well as the surgical technique.
We managed to obtain good stable results in all cases in long-term period. Thanks to the timely performed and efficient complex treatment maximal aesthetic rehabilitation of the children with congenital oblique facial clefts was achieved to the age of 14-16, in cases of the acquired deformations of the eyelids and tissues of periorbital area - during 1-1.5 years from the moment of patient's apply to the clinic.
Differentiated approach to application of wide rotation bucco-zygomatic and frontal flaps and techniques of free skin and mucous tunic auto-grafting with simultaneous strengthening of the supporting palpebral structures allow to significantly extend the opportunities of reconstructive surgery in pediatric practice, increase the efficiency of treatment and obtain early medical and social rehabilitation of the patients with congenital and acquired deformations and defects of the eyelids.

congenital deformations of the eyelids, deformations of facial skeleton, microcirculation, rehabilitation