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Anatomical description of the upper tarsal plate for reconstruction

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A Letter to the Editor to this article was published on 19 July 2019

Abstract

Background

Reconstruction of the upper eyelids following traumatic, congenital and tumor surgeries is often difficult owing to a variety of reasons including the influence of the lacrimal system, visual system and aesthetic appearance. In most cases of the reconstruction in the upper eyelid tarsal plate is the main anatomical area that should be protected against the damage. The aim of this study is to investigate the types and the measurements of the tarsal plate of the upper eyelids in Anatolian population.

Methods

Fifty cadaver upper eyelids, tarsal plates were exposed to investigate the location, shape, position and their relationships to the upper eyelid. Their morphometric details such as linear analyses (vertical and horizontal) and ratio analyses were studied. As for the shape of the upper tarsal plate, it was categorized into three distinct types: sickle, trapezoid, and triangular type.

Results

The vertical height of the upper tarsal plate was the greatest at the central point 10.6 ± 1.1 mm, followed by the lateral point (7.81 ± 1.0 mm), and medial point (6.2 ± 0.8 mm) medially. The mean medial width of the upper tarsal plate was measured as 37.6 ± 4.1 mm and the lower width as 38.5 ± 4.6 mm. The base-central height ratio of the upper tarsal plate was approximately 0.28. For the upper eyelids, the shapes of tarsal plates were observed as sickle (48%), trapezoid (28%) and triangular (24%). Sickle type was the most frequent upper eyelid type.

Conclusions

Considering the shielding function of the upper eyelid, tarsal plate, serves as fibrocartilaginous skeleton of the upper tarsal plate. In successful lid oculoplastic reconstructive surgery, tarsal plate may be restored by evaluating each patient individually to have symmetrical and youthful eyes. Although sickle tarsal plate is the most frequent type, personalized treatment requires measurement and classification. The findings manifest the necessity of oculoplastic surgical treatment peculiar to each individual.

Level of evidence

I, Randomized controlled trial.

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Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey

    Istemihan Coban, Suzan Sirinturk, Fuat Unat, Yelda Pinar & Figen Govsa

Authors
  1. Istemihan Coban
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  2. Suzan Sirinturk
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  3. Fuat Unat
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  4. Yelda Pinar
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  5. Figen Govsa
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Contributions

IC: data collection. SS: protocol/project development. FU: data collection and provision of materials. YP: conception and design; provision of materials and literature search. FG: conception and design; writing the article; statistical expertise.

Corresponding author

Correspondence to Figen Govsa.

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Conflict of interest

All the authors certify that they have no potential conflicts of interest with any entity mentioned in this manuscript and that they received no specific financial support for this work.

Ethical approval

This study was approved by the ethics committee of Ege University Hospital. We declare that this human study have been approved by the ethics committee of Ege University and have, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Coban, I., Sirinturk, S., Unat, F. et al. Anatomical description of the upper tarsal plate for reconstruction. Surg Radiol Anat 40, 1105–1110 (2018). https://doi.org/10.1007/s00276-018-2064-7

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  • DOI: https://doi.org/10.1007/s00276-018-2064-7

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