Can A Horse Eyelid Be Repaired More Than Once

Surgery, Anaesthesiology and Radiology Department, Kinesthesia of Veterinary Medicine, Mansoura University, Egypt

*Corresponding authors:

Awad Rizk Surgery, Anaesthesiology and Radiology Section Kinesthesia of Veterinarian Medicine Mansoura University, Arab republic of egypt Tel: +0020-1099513339 Fax: +0020-50-2379952 E-mail service: [email protected] com

 Received Nov 06, 2022; Published November 09, 2022  Citation: Rizk A (2012) Lower Eyelid Reconstructive Surgery after Melanoma Resection in a Equus caballus. 1:514. doi:ten.4172/scientificreports.514  Copyright: © 2022 Rizk A. This is an open-access commodity distributed under the terms of the Creative Eatables Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  Abstract  A v-year-old gray Arabian horse was presented with a left lower eyelid mass. No other abnormality was detected on the affected eye in a general eye examination. The mass was histologically diagnosed every bit a melanoma. Equally treatment, surgery was proposed. During the surgery consummate excision of the tumor was performed. The extent of skin loss in the lower eyelid required plastic reconstruction, and so the sliding peel flap technique was performed. Successful treatment of lower eyelid melanoma was achieved by surgical removal. There has been no recurrence during the subsequent 6 months. In this example, reconstruction of the lower eyelid by sliding skin flap resulted in satisfactory functional and cosmetic upshot.  Keywords  Horse; Lower Eyelid; Melanoma; Blepharoplasty; Sliding skin flap  Introduction  Reconstructive blepharoplasty is indicated in whatever horse in which trauma or surgical excision has removed more one third of the eyelid margin. This type of surgery is best performed under general anaesthesia. Information technology should be remembered that although the eyelid skin is pliable, the surrounding facial skin is relatively inelastic and may not stretch readily to provide donor peel [ane,2].  Melanomas are mutual in grayness horses and rare in other colors of equus caballus. They commonly nowadays as nodules in the eyelid and often involve the eyelid margin. They rarely ulcerate and are most oftentimes of a benign slow growing nature [two,3]. They are most often benign in the horses [4] and canis familiaris [v], but oftentimes cancerous in the cat [6]. If the eyelid mass involves less than about 1 third of the eyelid margin, removal tin be performed in a routine fashion. If the mass involves more than one third of the eyelid margin, reconstruction of the eyelid will be necessary. This may require more complicated procedures, and sometimes more than one surgery will be needed to fully reconstruct the eyelid [1,ii,vii].  The case report hither describes reconstructive surgery of the lower eyelid with a sliding pare flap technique afterward surgical excision of a melanoma in Arabian horse.  Case Report  A 5-yr-old gray Arabian horse was presented to Mansoura veterinary teaching hospital of the faculty of veterinary medicine mansoura university, Mansoura, Egypt for evaluation of a left lower eyelid mass (Figure 1A). The mass had been present for approximately six months but had recently increased in size. The horse was generally in adept physical condition. Ophthalmic examination and hematologic test appeared normal except the mass of the lower eyelid. Â

Figure i: A. A half dozen-yr-erstwhile gray Arabian horse with black not ulcerated nodule, hemispherical in shape and raised from the peel surface of the lower eyelid. B. Showing surgical resection of the mass (white arrow), the horse restrained in lateral recumbency under general amazement. C. A black non-ulcerated nodular mass after resection in a half-dozen-year-erstwhile greyness Arabian horse. The mass was measured virtually 1x1.5x0.5 cm. D. Melanotic melanoma; 6-year-former gray Arabian horse. X520, H&E. Note intracytoplasmic dumbo brownish black pigment (melanin) which obscures the cellular details too gristly tissue trabeculae were seen among them.

 On the day of surgery, the horse was premedicated with intravenous injection of acepromazine (Vetranquil 1%, Libourne Cedex, French republic) at a dose of 0. 05 mg/kg BW. Anesthesia was induced and maintained by infusion of a freshly prepared mixture of 500 mg xylazine HCl, 40 mg midazolam, and 2 g ketamine HCl dissolved in i Fifty of 5% dextrose and the beast was restraint in the lateral recumbency. Afterwards surgical resection of the mass (Figure 1B) a significant loss of tissue was appeared which require a surgical technique for reconstruction of the lower eyelid. The incisions were extended vertically for twice the height of the excised portion (Figure 2A). Slightly diverging incisions permit for wound contracture were performed. Triangular pieces of skin were excised at the stop of each incision (Figure 2A). These triangles facilitate closure without skin folds (dog-ears) and help to distribute tension. The sides of the triangle was approximate the meridian of the excised portion. Surrounding peel was undermined with scissors to provide skin mobility. Peel closure was begun at the eyelid margin (Figure 2B) using a 4-0 polyglactin 910 (PDS, Ethicon). The flap was sutured to the underlying conjunctiva along the eyelid margin with 4-0 PDS in a uncomplicated continuous pattern (Effigy 2C). Flunixin-Meglumin (i. 1 mg/kg) was given to animal for 5 days postoperatively. A follow-upwards through the phone for six months post-surgery was performed. Â

Figure 2: A. Vertical extension of the incisions in the lower eyelid of a 6-twelvemonth-old greyness Arabian horse twice the superlative of the excised portion with slight diversion. A triangular piece of skin was excised at the terminate of each incision (white arrows). The sides of the triangle is approximate the height of the excised portion. B. Showing closure of the side of the triangle and the top of the flap (white arrows) was performed using 4-0 PDS. C. The flap was sutured to the underlying conjunctiva along the eyelid margin with 4-0 PDS in a simple continuous design. D. Removal of the sutures and healing of the lower eyelid wound ii weeks subsequently surgery in a 6-twelvemonth-one-time gray Arabian horse.

 Results  The lesion appeared as black non ulcerated nodule, hemispherical in shape and rose from the skin surface. The mass was centered and adjacent to the lower eyelid margin which extend in length and include more than ane third of the lower eyelid. The size of the excised mass was approximately 1×i. 5×0. 5 cm (Figure 1C).  Microscopic test of the lesion showed a dome-shaped extrusion of the epidermis and the presence of heavily pigmented areas consisted of concentric ring of cells at different densities, each beingness separated by connective tissue. In association with these areas, lightly pigmented tumorous masses were plant, similar to those near apocrine sweat glands in the plaque-like tumours. Apoptotic bodies were present (Figure 1D).  The wound was healed by first intention and the suture was removed within two weeks after the surgery (Effigy 2D).  During a follow-upwardly through the phone for 6 months post-surgery, the horse completely recovered and any recurrence or complications was not observed. Reconstruction of the lower eyelid resulted in satisfactory functional and cosmetic outcome.  Discussion  Successful treatment of lower eyelid melanoma can be achieved by ‘‘en bloc’’ surgical removal. In this instance, reconstruction of the lower eyelid past sliding skin flap resulted in satisfactory functional and cosmetic outcome.  The equine eye and adnexa are frequent sites of tumors [eight-10]. The eyelid, in item, has been reported to exist affected by squamous cell carcinoma, sarcoid, melanoma, and with much less frequency by papillomas, adenomas, adenocarcinomas, mast cell tumors, basal cell tumour, haemangioma, hemangiosarcomas, lymphosarcomas, fibromas, and schwannomas [viii-10]. Amongst these, squamous prison cell carcinoma and sarcoid are past far the most common tumours of the equine eyelid. Melanomas are normally found every bit nodules in the eyelids and can involve orbital tissues likewise, it was the commonest intraocular tumour of the equus caballus just in any case it is still rare at this site [3,eleven]. As far as we know, this is the first description of a lower eyelid melanoma presenting in the horse, which treated with reconstructive blepharoplasty. Welker et al. [vii] performed a broad surgical excision and H-blepharoplasty of the lower eyelid for removal of a neoplasm’s in 14 cattle, and he conclude that, healing was by first intention, and cosmetic results likewise every bit lid office were satisfactory in all cases.  Surgical excision is a realistic proposition provided that the tumour can exist removed without significant peel impairment, eyelid functional compromise or scarring. This usually involves removal of a small portion of the eyelid margin and scrupulous reconstructive surgery to prevent the complications arising from poor eyelid role [2].  Small superficial triangular cardinal defects in the lower eyelids can be closed directly, creating a new lid edge in the lateral canthus (inverse triangles method). Larger superficial triangular defects may exist covered using a distant inverse triangle to gain tissue (rotating flap technique). Full thickness lower eyelid defects can be corrected successfully by direct apposition if the defect does not exceed more than one-3rd of the eyelid margin [12]. Wider square defects crave an advocacy flap obtained by H-plasty [seven,12]. Extensive defects involving the dorsolateral eyelid can be covered using a pedicle graft or by a cross-lid flap obtained from the lower eyelid [13]. Large upper eyelid defects have been managed with a modified cross-lid flap technique [14,15]. Complete loss of the lower eyelid with canthus preservation can be managed by a lip-to-chapeau technique [16,17]. Total thickness rectangular defects of the lower eyelid can be reconstructed creating a full thickness advancement flap from the upper eyelid, using the and so-called ‘‘bucket handle’’ technique [18]. In this case, the part of the eyelid removed with the tumour is large, from 1-quarter to one-third of its length, for such reason this defect was reconstructed with sliding skin flap technique. A slight overcorrection that is, bringing the flap slightly across the desired level of the eyelid margin results in a meliorate corrective advent afterwards wound contracture in such technique. Like reconstructed blepharoplasty of the eyelids defects were performed in cattle [seven] and dogs [18-21].  Information technology was ended that, blepharoplasty with a sliding skin flap technique should exist considered for reconstruction of the lower eyelid defects in horses with ≤ 50% tissue loss of the lid margin following resection of a neoplasm mass.  References Â

1. Miller TR (2006) Eyelids. In: Auer, J. and Stick, J. 3rd ed. Equine surgery.Saunder, Philadelphia, PA, U.s.a.. pp 702-715.

2. Knottenbelt DC (2012) Ocular, Orbital and Periorbital Neoplastic Conditions of the Horse. University of Stirling, Stirling, Scotland.

3. Matthews AG, Barry DR (1987) Bilateral melanoma of the iris in a equus caballus. Equine Vet J 19: 358-360.

4. Wilcock BP (1993) Ocular Neoplasia. In Pathology of domestic animals, 4th Edition, Vol. 1, K. V. F. Jubb, P. C. Kennedy and Due north. Palmer (eds.), Academic Press, San Diego, California.

5. Withrow SJ, Vail DM (2007) Small Animal Clinical Oncology. (4Edn), Saunders Elsevier, St Louis, USA.

6. Pullery LT, Stannard AA (1990) Tumor of the pare and soft tissues-Introduction. In Tumors in domestic animals, (3Edn). J. E. Moulton (ed.), University of California Printing, Berkeley, California.

7. Welker B, Modransky PD, Hoffsis GF, Wyman MW, Rings DM, et al. (1991) Excision of neoplasms of the bovine lower eyelid past H-blepharoplasty. Vet Surg twenty: 133-139.

8. Bolton JR, Lees MJ, Robinson WF, Thomas JB, Klein KT (1990) Ocular neoplasms of vascular origin in the horse. Equine Vet J Suppl : 73-75.

9. Rebhun WC (1998) Tumors of the eye and ocular adnexal tissues. Vet Clin N Am Equine Pract 14: 579-606, 7.

10. Baptiste KE, Grahn BH (2000) Equine orbital neoplasia: a review of x cases (1983-1998). Tin Vet J 41: 291-295.

11. Moore CP, Collins BK, Linton LL, Collier LL (2000) Conjunctival cancerous melanoma in a horse. Vet Ophthalmol 3: 201-206.

12. Stades FC (1987) Reconstructive eyelid surgery. Tijdschr Diergeneeskd 112 Suppl 1: 58S-63S.

13. Munger RJ, Gourley IM (1981) Cantankerous lid flap for repair of large upper eyelid defects. J Am Vet Med Assoc 178: 45-48.

14. Meek LA, Brooks DE, Miller TR (1994) Eyelid reconstruction in five dogs by the semicircular flap technique. Vet. Comp. Ophthalmol.

15. Esson D (2001) A modification of the Mustardé technique for the surgical repair of a large feline eyelid coloboma. Vet Ophthalmol 4: 159-160.

16. Pavletic MM, Nafe LA, Confer AW (1982) Mucocutaneous subdermal plexus flap from the lip for lower eyelid restoration in the dog. J Am Vet Med Assoc 180: 921-926.

17. Schmidt K, Bertani C, Martano M, Morello E, Buracco P (2005) Reconstruction of the lower eyelid past third eyelid lateral advancement and local transposition cutaneous flap after "en bloc" resection of squamous prison cell carcinoma in 5 cats. Vet Surg 34: 78-82.

18. Gelatt KN, Gelatt JP (2001) Small Fauna Ophthalmic Surgery. practical techniques for the veterinarian Butterworth-Heinemann, Oxford.

19. Lewin G (2003) Eyelid reconstruction in seven dogs using a split eyelid flap. J Pocket-sized Anim Pract 44: 346-351.

20. Jacobi S, Stanley BJ, Petersen-Jones South, Dervisis Due north, Dominguez PA (2008) Use of an axial pattern flap and nictitans to reconstruct medial eyelids and canthus in a dog. Vet Ophthalmol eleven: 395-400.

21. Martin CL (2010) Ophthalmic Illness in Veterinary Medicine, (4edn).Manson Publishing Ltd, London.

 Â

Can A Horse Eyelid Be Repaired More Than Once,

Source: https://www.omicsonline.org/scientific-reports/srep514.php

Posted by: velazquezforyinath76.blogspot.com

Share this post