Clinical application of modified kite flap in treatment of divided nevus of lateral canthus_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHENG Shuwen ,  WEN Huicai , HUANG Jinjun , FU Jianhua , LU Yingjie , LIAO Huaiwei , TU Jun

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China;

Corresponding author：

WEN Huicai, Email: whcjxmc@163.com

Keywords：

Divided nevus of lateral canthus; modified kite flap; lateral canthus reconstruction; cosmetic repair

DOI：

10.7507/1002-1892.201905012

Video：

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Objective To investigate the effectiveness of modified kite flap in repair of soft tissue defect after divided nevus of lateral canthus excision.Methods Between October 2010 and April 2018, 20 children (20 eyes) with divided nevus of lateral canthus were admitted. There were 13 boys and 7 girls, with an average age of 7.9 years (mean, 4-14 years). There were 11 cases of moderate range lesions (maximum diameter, 1.5-2.0 cm) and 9 cases of small range lesions (maximum diameter, <1.5 cm). After excising the divided nevus of lateral canthus, the area of soft tissue defect ranged from 0.72 to 3.23 cm². The modified kite flap was used to reconstruct the structure and shape of lateral canthus.Results There were 16 cases of mixed nevus and 4 cases of intradermal nevus. The flaps survived and the incisions healed by the first intention. The patients were followed up 12-22 months (mean, 13.6 months). There was no malformation, valgus, exposure keratitis, or obvious scar. No malignant transformation occurred or nevus recurred during follow-up. At last follow-up, the effectiveness was rated as excellent in 16 cases, good in 3 cases, and poor in 1 case.Conclusion The modified kite flap can repair the soft tissue defect after excising the divided nevus of lateral canthus, and obtain the good appearance and function of lateral canthus.

Citation： SHENG Shuwen, WEN Huicai, HUANG Jinjun, FU Jianhua, LU Yingjie, LIAO Huaiwei, TU Jun. Clinical application of modified kite flap in treatment of divided nevus of lateral canthus. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(12): 1556-1559. doi: 10.7507/1002-1892.201905012 Copy

1.	Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol, 2005, 52(2): 197-203.
2.	Desai SC, Walen S, Holds JB, et al. Divided nevus of the eyelid: review of embryology, pathology and treatment. Am J Otolaryngol, 2013, 34(3): 223-229.
3.	Bhattacharjee K, Singh M, Bhattacharjee H. Amniotic membrane graft to reconstruct divided nevi of eyelids. BMJ Case Rep, 2015. doi: 10.1136/bcr-2014-209020.
4.	Jia R, Zhu H, Lin M, et al. Clinicopathological characteristics and surgical outcomes of divided nevus of the eyelids: a decade’s experience on 73 cases. Ann Plast Surg, 2012, 68(2): 166-170.
5.	张鲜英, 刘毅, 张诚, 等. 眼睑不同部位分裂痣的修复方法. 中国美容整形外科杂志, 2017, 28(7): 433-435.
6.	张辰晨, 邓远, 李政康. 改良切口联合局部滑行肌皮瓣一期修复中小范围眼睑分裂痣. 中国美容医学, 2018, 27(4): 22-24.
7.	Ke Y, Ren X, Zhu L, et al. Primary orbital melanoma combined with giant divided nevus of the eyelid. J Craniofac Surg, 2014, 25(1): e4-e7.
8.	Watt AJ, Kotsis SV, Chung KC. Risk of melanoma arising in large congenital melanocytic nevi: a systematic review. Plast Reconstr Surg, 2004, 113(7): 1968-1974.
9.	王晓军, 朱琳, 刘志飞, 等. 岛状皮瓣一期修复眼睑分裂痣的设计与技巧. 中华整形外科杂志, 2010, 26(1): 15-17.
10.	Chang EI, Esmaeli B, Butler CE. Reply: The value of secondary intention healing in eyelid reconstruction: response to recent CME article by Chang, Esmaeli, and Butler—Content needs to be evidence-based. Plast Reconstr Surg, 2018. doi: 10.1097/PRS.0000000000004305.
11.	聂晶晶, 郑春梅, 董雪, 等. 眼睑分裂痣切除后的美容修复. 中华医学美学美容杂志, 2018, 24(2): 136-137.
12.	陈健, 李暐. 带蒂组织瓣在头颈部肿瘤术后缺损修复重建中的应用研究进展. 中国修复重建外科杂志, 2018, 32(3): 369-376.
13.	李秀琪, 王太玲, 李无言, 等. 眼睑分裂痣的手术方法选择. 中华整形外科杂志, 2015, 31(2): 96-99.
14.	Singh M, Gautam N, Kaur M, et al. Role of amniotic membrane and full-thickness skin graft in reconstruction of kissing nevus of eyelids. Indian J Ophthalmol, 2017, 65(11): 1219-1221.
15.	倪晓静, 王坤. " 风筝”皮瓣修复面部皮肤缺损的临床应用. 中国美容医学, 2018, 27(4): 27-29.
16.	Choi J, Lee Y. Bipedicled skin flap in the treatment of divided nevus of the eyelid. Dermatol Surg, 2014, 40(1): 62-65.
17.	Hu L, Jin Y, Tremp M, et al. Reconstruction of a large divided nevus of the eyelid. Dermatol Surg, 2017, 43(12): 1483-1486.
18.	文辉才, 万珺, 眭云鹏, 等. 肌皮瓣法重睑术的临床疗效分析. 中国修复重建外科杂志, 2017, 31(3): 327-330.
19.	刘龙灿, 刘元波, 臧梦青, 等. 以颞浅血管顶支为蒂的扩张头皮岛状瓣再造鬓角的临床研究. 中国修复重建外科杂志, 2017, 31(11): 1358-1362.

1. Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol, 2005, 52(2): 197-203.
2. Desai SC, Walen S, Holds JB, et al. Divided nevus of the eyelid: review of embryology, pathology and treatment. Am J Otolaryngol, 2013, 34(3): 223-229.
3. Bhattacharjee K, Singh M, Bhattacharjee H. Amniotic membrane graft to reconstruct divided nevi of eyelids. BMJ Case Rep, 2015. doi: 10.1136/bcr-2014-209020.
4. Jia R, Zhu H, Lin M, et al. Clinicopathological characteristics and surgical outcomes of divided nevus of the eyelids: a decade’s experience on 73 cases. Ann Plast Surg, 2012, 68(2): 166-170.
5. 张鲜英, 刘毅, 张诚, 等. 眼睑不同部位分裂痣的修复方法. 中国美容整形外科杂志, 2017, 28(7): 433-435.
6. 张辰晨, 邓远, 李政康. 改良切口联合局部滑行肌皮瓣一期修复中小范围眼睑分裂痣. 中国美容医学, 2018, 27(4): 22-24.
7. Ke Y, Ren X, Zhu L, et al. Primary orbital melanoma combined with giant divided nevus of the eyelid. J Craniofac Surg, 2014, 25(1): e4-e7.
8. Watt AJ, Kotsis SV, Chung KC. Risk of melanoma arising in large congenital melanocytic nevi: a systematic review. Plast Reconstr Surg, 2004, 113(7): 1968-1974.
9. 王晓军, 朱琳, 刘志飞, 等. 岛状皮瓣一期修复眼睑分裂痣的设计与技巧. 中华整形外科杂志, 2010, 26(1): 15-17.
10. Chang EI, Esmaeli B, Butler CE. Reply: The value of secondary intention healing in eyelid reconstruction: response to recent CME article by Chang, Esmaeli, and Butler—Content needs to be evidence-based. Plast Reconstr Surg, 2018. doi: 10.1097/PRS.0000000000004305.
11. 聂晶晶, 郑春梅, 董雪, 等. 眼睑分裂痣切除后的美容修复. 中华医学美学美容杂志, 2018, 24(2): 136-137.
12. 陈健, 李暐. 带蒂组织瓣在头颈部肿瘤术后缺损修复重建中的应用研究进展. 中国修复重建外科杂志, 2018, 32(3): 369-376.
13. 李秀琪, 王太玲, 李无言, 等. 眼睑分裂痣的手术方法选择. 中华整形外科杂志, 2015, 31(2): 96-99.
14. Singh M, Gautam N, Kaur M, et al. Role of amniotic membrane and full-thickness skin graft in reconstruction of kissing nevus of eyelids. Indian J Ophthalmol, 2017, 65(11): 1219-1221.
15. 倪晓静, 王坤. " 风筝”皮瓣修复面部皮肤缺损的临床应用. 中国美容医学, 2018, 27(4): 27-29.
16. Choi J, Lee Y. Bipedicled skin flap in the treatment of divided nevus of the eyelid. Dermatol Surg, 2014, 40(1): 62-65.
17. Hu L, Jin Y, Tremp M, et al. Reconstruction of a large divided nevus of the eyelid. Dermatol Surg, 2017, 43(12): 1483-1486.
18. 文辉才, 万珺, 眭云鹏, 等. 肌皮瓣法重睑术的临床疗效分析. 中国修复重建外科杂志, 2017, 31(3): 327-330.
19. 刘龙灿, 刘元波, 臧梦青, 等. 以颞浅血管顶支为蒂的扩张头皮岛状瓣再造鬓角的临床研究. 中国修复重建外科杂志, 2017, 31(11): 1358-1362.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of modified kite flap in treatment of divided nevus of lateral canthus

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