The Use of the Orbital Septum in Inferior Palpebral Reconstruction: The Pocket Technique

Abstract

Background: Surgery involving massive inferior palpebral demolition often imposes the use of free flaps for the reconstruction of the anterior and posterior lamellae. Purpose: We describe a surgical technique which provides for the use of a homologous pedunculated elastic flap on which we wrap the free flap as in a pocket, in order to guarantee that the free flap itself takes root better. Methods: A study of 10 patients admitted to our hospitals for massive inferior palpebral demolition surgery between March 2002 and November 2004 was undertaken, and clinical records (age, sex, involved site of lesions, surgery technique) were accurately noted: in all patients we performed the ‘pocket technique’. Results: The pocket technique has encouraged optimal attachment of the implanted free tissue, in absence of necrotic phenomena or tissue extrusion. Conclusions: Reconstructive surgery of the inferior eyelid avails itself of consolidated techniques. In case of extreme tissue reduction, the variation we wish to suggest is simple to understand and easy to perform, significantly reducing inflammatory reaction and/or post-surgical rejection, allowing excellent aesthetic results.