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Shilpa Gillella Reddy, James Christian Fleming, Brian Fowler, Salil Kumar Mandal; Total Upper Eyelid Reconstruction with Modified Cutler-Beard Procedure Using Autogenous Auricular Cartilage. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4742.
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In this study, we aim to evaluate the efficacy of the modified Cutler-Beard procedure using autogenous ear cartilage for tarsal plate reconstruction in the repair of upper eyelid defects greater than 70%, as the procedure is traditionally used only for lid large lid defects up to 70%. In addition, we aim to discuss cost and safety of using autogenous ear cartilage rather than other alternatives, such as synthetic graft tissue and allografts, for tarsal plate reconstruction.
This is a retrospective, interventional case series of eight patients over a period of three years. All patients had malignant tumors of the upper lid requiring removal of 70-100% of the upper eyelid. All patients’ lid defects were repaired using a modified Cutler-Beard procedure, utilizing autogenous auricular cartilage for stability of the lid that the tarsal plate normally imparts. Patient were followed over a period of six months to one year with postoperative ophthalmologic examinations and photos at each visit.
Upper eyelid recreation was successful in all cases without complications. The autogenous auricular cartilage graft maintined excellent architecture and motility in all patients at follow-up visits, resulting in good cosmetic result and functionality.
The modified Cutler-Beard procedure using an autogenous auricular cartilage graft is an effective procedure for repair of eyelid defects greater than 70%, with good functional and cosmetic results. Moreover, it is particularly useful in resource-poor areas, due to lower cost than other available options, such as the use of synthetic graft tissue and allograft materials.
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