Autogenous hard palate mucosa: the ideal lower eyelid spacer?

Abstract

Background/aims-Raising a displaced lower eyelid frequently involves recession of the lower eyelid retractors with interposition of a "spacer," and several materials for this purpose have been described. This study reviewed the results of autogenous palatal mucosa in the treatment of lower eyelid displacement, including assessment of any donor site morbidity.

Porcine Dermal Collagen in Lower Eyelid Retraction Repair

“…3 Hard palate mucosa has become one of the most commonly used posterior lamella spacer grafts. 1,3,4,22,23,[46][47][48][49] The hard palate is formed by the palatine processes of the maxilla and the horizontal processes of the palatine bones with the overlying soft tissue. 72 It forms the roof of the oral cavity and the floor of the nasal cavity.…”

“…Additionally, the use of synthetic materials including polytetrafluoroethylene 29,30 and porous polyethylene 31-34 has also been described. Autogenous and irradiated tarsus, [35][36][37][38] donor sclera, 39,40 dermis grafts, 41 auricular cartilage, 20,42-45 cadaveric dermal collagen, 1 and hard palate mucosal grafts 1,3,4,22,23,[46][47][48][49][50] have also been used with varying success rates. The auricular cartilage and hard palate mucosal grafts have probably enjoyed the most use.…”

Korrektur von Unterlidretraktion mittels eines porösen Polyethylen (Medpor®) Unterlidimplantats

“…Vorteile gegenüber Biomaterialien wie Sklera, Ohrknorpel, harter Gaumen, azelluläre Dermis oder Tarsus sind bessere Verfügbar-keit, keine möglichen Komplikationen an der Entnahmestelle, keine Spendermaterialrisiken wie z. B. Infektiosität, sowie kosten-, operationstechnische und anästhesiologische Erwägungen [7,15,19,21,29]. Nachteile wie Behinderung und Gesichtsfeldeinschrän-kung beim Blick nach unten, Extrusion und höhere Revisionsraten lassen sich in einem gewissen Maße durch Operationstechnik und sorgfältige Indikationsstellung beeinflussen.…”

“…Wie auch bei allogenen azellulären Hauttransplantaten werden bei Skleraimplantaten Rezidive aufgrund von Absorption und Fibrosierung des Spendermaterials beobachtet [4,19,23,26]. Autogene Transplantate wie Mucosa des harten Gaumens, Tarsus oder Ohrknorpel bedeuten operativen Mehraufwand und es kann zu Komplikationen an der Entnahmestelle kommen [6,7,13,15,21,29]. Künstliche Spacermaterialien wie Mersilene oder Polytetrafluoroethylen wiesen in Studien relativ hohe Extrusionsraten auf [2,5,11,12].…”

Polytetrafluoroethylene as a Spacer Graft for the Correction of Lower Eyelid Retraction

“…Autogenous grafts including ear cartilage, hard palate and tarsal plate are limited by the amount of donor material available, donor site morbidity and increased operating time for graft harvesting. [7][8][9] Therefore, searches have been conducted for synthetic graft materials that avoid some of these drawbacks and are easy to obtain and well tolerated.…”