Operation nach Hughes und damit kombinierte Verfahren

Emesz, Martin; Krall, Eva Maria; Nischler, C.; Rasp, Max; Dexl, Alois K.; Bauer, F.; Grabner, Günther; Arlt, Eva Maria

doi:10.1007/s00347-013-2918-7

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…The high functional-esthetical success rate of the modified Hughes procedure, observed in this study, corresponds with the beneficial results, which have been reported in previous publications [ 14 – 17 ]. Also, with regard to the vast majority of BCC followed by SCC as underlying tumor entities, the study population shows a typical distribution [ 14 , 18 ].…”

Section: Discussionsupporting

confidence: 91%

“…Notably, although Müller’s muscle remained attached to the tarsus, we did not observe a single case of upper lid retraction. The only donor-site complication occurring in this study was a single case of moderate entropium with trichiasis, a finding, which has been described as well in individual cases after complete Müller’s muscle disinsertion from the tarsus [ 14 , 17 ]. In view of this fact, this surgical approach appears suitable not least because a more robust and thicker flap pedicle should reduce the risk of a premature flap dehiscence and consecutively of hypoperfusion and necrosis of the tarsal autograft.…”

Section: Discussionsupporting

confidence: 54%

“…Currently, most authors recommend to completely separate the levator as well as the Müller’s muscle from the superior tarsal border during Hughes flap preparation thereby leaving a very delicate and thin pedicle only consisting of conjunctiva for tarsal blood supply (Fig. 4 b) [ 14 ]. In this study a different incisional plane—previously described by McCord and Nunery—was chosen [ 21 ], which indeed separates the entire levator muscle from the tarsus, while leaving the majority of Müller’s muscle fibers attached to the superior tarsal margin (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection

et al. 2016

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BackgroundTarsoconjunctival flap advancement, or the Hughes procedure, is among the techniques of choice for reconstructing full-thickness lower eyelid defects so as to restore normal anatomy and function with the best possible cosmetic outcome. The purpose of this study is to report the outcome of a series of patients treated with a modified Hughes procedure following malignant tumor removal.MethodsThis retrospective study included 45 consecutive cases of modified Hughes procedures performed between January 2013 and October 2015. During Hughes flap creation an incisional plane was chosen in all cases, which left Müller’s muscle attached to the superior tarsal margin, while disinserting the levator aponeurosis. All cases were grouped according to the horizontal length of the lower lid defect to be reconstructed, as well as to the type of anterior lamella reconstruction (free graft vs. inferiorly based advancement flap). Grouped data were compared for the rate of surgical success, defined as achievement of normal lid function and satisfactory cosmesis without needing further surgical interventions, and for the frequency of specific complications.ResultsSurgical success was achieved in 39 cases (87 %). The remaining cases required additional surgery for minor complications including lower-lid ectropion (4 %), pyogenic granuloma (4 %), or lower lid margin hypertrophy (2 %). Donor-site complications were not detected apart from one case of mild entropion with focal trichiasis. No case of premature flap rupture was seen. Neither the horizontal length of the lower lid defect (p = 0.489), nor the type of anterior lamella reconstruction (p = 0.349) significantly affected the surgical success. Particularly, there was no increased onset of lower-lid ectropion among patients receiving an advancement flap.ConclusionsThe modified Hughes procedure remains a well-suited technique for reconstructing lower eyelid defects involving up to 100 % of the horizontal lid length. Leaving Müller’s muscle attached to the Hughes flap might prevent premature flap dehiscence without increasing the frequency of upper lid retractions in turn. Whether using a free skin graft or a skin-muscle advancement flap for anterior lamella reconstruction, seems to be insignificant for the functional-aesthetical outcome.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection

et al. 2016

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“…The procedure was proved to be a well-suited technique for eyelid reconstruction of shallow defects extending beyond 10 mm horizontally and involving up to 100% of the eyelid. 8 …”

Section: Discussionmentioning

confidence: 99%

Longevity results of modified Hughes procedure in reconstructing large lower eyelid defects

Zaky

Elmazar

Elaziz

2016

OPTH

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PurposeThe purpose of this study was to evaluate the longevity results of modified Hughes procedure in reconstructing large lower eyelid defects.BackgroundThe modified Hughes procedure was used to reconstruct large full-thickness lower eyelid defects. Meanwhile, the functional results indicated that ocular surface health in the treated eyes may be affected.Patients and methodsNoncomparative, case series retrospective study was designed after obtaining the approval of the institutional review board at the Ophthalmology Department, Menoufia University, Egypt, where the results of cases who underwent surgery with the modified Hughes procedure during a 7-year interval were evaluated.ResultsEleven patients (seven males and four females) in the age range 59–77 years (mean age 67±5 years) were identified. The follow-up ranged from 12 months to 48 months. Cosmetic, functional, and postoperative results were analyzed.ConclusionDespite the favorable cosmetic results of the Hughes tarsoconjunctival flap, the procedure has its own limitations. The results indicated that it does affect the functions and tear film stability in the treated eyes.

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“…Bei unseren Patienten waren Defekte bis 28 mm unter Verwendung der Hughes-Plastik in Kombination mit anderen rekonstruktiven Prozeduren gut wiederherzustellen. Prinzipiell decken sich diese Ergebnisse und die aufgetreten Komplikationen mit denen anderer Autoren [11,12]. Das 1937 von Hughes erstbeschriebene Verfahren [13] eignet sich insbesondere zur Deckung ausgedehnter Unterliddefekte und lässt sich bei kanthaler Mitbeteiligung sowohl isoliert ausführen als auch mit anderen Verfahren kombinieren [11].…”

Section: Materials Und Methodenunclassified

Deckung großer Unterliddefekte (mit Kanthusbeteiligung) mittels gestieltem Tarsokonjunktivallappen nach Hughes und freiem Hauttransplantat – Möglichkeiten und Grenzen

Sommer

Wozniak

2014

Klin Monatsbl Augenheilkd

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Operation nach Hughes und damit kombinierte Verfahren

Cited by 10 publications

References 17 publications

Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection

Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection

Longevity results of modified Hughes procedure in reconstructing large lower eyelid defects

Deckung großer Unterliddefekte (mit Kanthusbeteiligung) mittels gestieltem Tarsokonjunktivallappen nach Hughes und freiem Hauttransplantat – Möglichkeiten und Grenzen

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