Reconstruction of full thickness lower lid defects using Texier’s procedure: retrospective assessment of the indications

Publication date: Available online 20 September 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sarra Cristofari, Kessara Rem, Marc Revol, Michael Atlan, Alessio Stivala

Abstract

Purpose

Lower-lid defects involving more than 75% of lid's length or attaining the cheek are usually reconstructed by a Mustardé rotational cheek flap. This solution often induces a postoperative ectropion. Texier's procedure (upper lid myocutaneous flap and a chondro-mucosal alar graft) is usually indicated for one-step reconstruction of less than 50% long full thickness defects of the lower lid. This retrospective study aimed to evaluate larger indications of Texier's procedure for full thickness defects of the lower lid, and the results on defects longer than 50% or even 75% of the length of the lid, in combination with a chondromucosal nasal septal graft for over 75% length-defects.

Materials and Methods

All lower lid reconstructions using Texier's procedure over a period of 29 months were retrospectively included. Data regarding post-operative complications, and patients' satisfaction were collected.

Results

Fifteen patients were included, of which one third had a 50% or less defect of the lower lid, one third presented with a defect from 50 to 75%, and one third had a defect of 75% or more. In this last group, reconstruction included a septal graft. The mean follow-up was 35 months. Transitory palpebral edema was present in 100% of patients, and lasted 8 months on average. No postoperative ectropion, nor nasal alar retraction on the graft donor site were observed. Mean satisfaction score was 2,86/3.

Conclusions

Texier's procedure can be used at first-line to reconstruct most full thickness defects of the lower lid, including subtotal lid-length defects.

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