Cicatricial iatrogenic lower eyelid malposition in skin cancer surgery: Results of a combined approach

Salgarelli, Attilio Carlo; Francomano, Mariangela; Magnoni, Cristina; Bellini, Pierantonio

doi:10.1016/j.jcms.2011.10.014

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…aim should be to repair the lax eyelid. Lateral or medial canthal plication or canthopexy 43 with medial tendon fixation posterior to the lacrimal sac, 44 lateral tarsal strip procedure with lateral tendon fixation inside the orbital rim 45 , or horizontal eyelid-shortening through wedge excision or Bick's procedure 46 with or without addressing the vertical vector cheek lift [47][48][49] (►Fig. 7) can be a viable option depending on the severity of laxity and the needs of the individual patient.…”

Section: Managing Complicationsmentioning

confidence: 99%

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

2020

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Periocular skin is highly prone to malignancies, especially basal cell and squamous cell carcinomas. Because of the complex anatomy and eye-protecting functions of the periocular tissues, treatment of these cancers requires special considerations. Mohs micrographic surgery is usually the treatment of choice, whenever possible, in order to enhance margin control while limiting collateral damage to nearby normal structures. Cancer excision, whether by Mohs or other techniques, will leave a complex defect that requires careful anatomical and functional reconstruction. This study presents some of the challenges of treating periocular skin cancer and associated reconstructive surgery and provides an intellectual framework for addressing these challenges. The key topics are adherence to anatomical landmarks and aesthetic units, proper distribution of tension, and matching the correct reconstructive approach, that is, type of flap or graft, to the defect at hand. This review is not meant to be exhaustive, but it will provide both basic and advanced considerations.

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Section: Managing Complicationsmentioning

confidence: 99%

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

2020

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“…Surgery to correct any malposition of the lower lid must address the underlying anatomic factors responsible for the condition (Salgarelli et al. ). In our case series, cicatricial ectropion resulted from a number of anatomic factors, including acquired vertical cicatricial traction, increased horizontal lid laxity and shortening of the anterior lamella.…”

Section: Discussionmentioning

confidence: 99%

“…This study shows favourable results of horizontal shortening using the lateral block excision technique in combination with adhesiolysis and skin grafting in patients with cicatricial ectropion. Surgery to correct any malposition of the lower lid must address the underlying anatomic factors responsible for the condition (Salgarelli et al 2012). In our case series, cicatricial ectropion resulted from a number of anatomic factors, including acquired vertical cicatricial traction, increased horizontal lid laxity and shortening of the anterior lamella.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of lateral eyelid‐block excision with canthoplasty and full‐thickness skin grafting in lower eyelid cicatricial ectropion

Mol

Paridaens

2018

Acta Ophthalmologica

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Purpose To report on the outcomes of our preferred surgical technique for the correction of lower eyelid cicatricial ectropion Methods We conducted a retrospective, nonrandomized, interventional analysis of a consecutive case series of patients with cicatricial lower lid ectropion treated with adhesiolysis, lateral eyelid‐block excision with canthoplasty and full‐thickness skin grafting. Donor sites included the ipsi‐ or contralateral upper eyelid and pre‐ or retroauricular skin. All patients were treated by one of our oculoplastic surgeons in the period from January 2005 to January 2017 in the Rotterdam Eye Hospital/Focus Clinic Rotterdam. We assessed postoperative lower eyelid apposition, the occurrence of intra‐ and postoperative complications and the reoperation rate. Results We included 38 eyelids of 32 patients, of whom 17 were male and 15 were female. The minimal postoperative follow‐up was 3 months. A total of 27 of 38 eyelids showed good postoperative apposition. Skin graft donor sites were the ipsi‐ or contralateral upper eyelid (47% and 16%, respectively) and the pre‐ or retroauricular skin (26% and 11%, respectively). No intraoperative complications occurred, but one patient developed a transient allergic contact dermatitis in the early postoperative phase. Two of 38 eyelids (two of 32 patients) required another surgical intervention (block excision) for residual or recurrent ectropion, with favourable outcomes. There was 100% viability of the skin grafts. Conclusion Repair of lower eyelid ectropion with lateral block excision, canthoplasty and full‐thickness skin grafting is an effective procedure with minimal donor site morbidity, excellent graft survival rates and a low reoperation rate.

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“…Para que a área doadora possa ser adequadamente fechada, um mínimo de 20mm de pele deve ser deixado entre a margem palpebral superior e a sobrancelha 11 . O pedículo do retalho é posicionado medialmente, tendo uma base larga, de modo a respeitar a proporção 1:3 (largura da base: comprimento Face I do retalho).…”

Section: Métodosunclassified

“…Geralmente, ocorre no contexto de casos de trauma, infecção, contratura de enxerto de pele 2 , frouxidão ligamentar do tarso, frouxidão horizontal da pele, paralisia do músculo orbicular entre outras 1 . Quando a margem palpebral fica exposta, um processo inflamatório secundário é desencadeado, o que acaba espessando o tarso, e piora o ectrópio por um fator mecânico 3 . A relevância do ectrópio está longe de ser puramente estética, uma vez que está associado à queratinização da conjuntiva, o que contribui para a irritação ocular, e pode levar à perda visual 1,4 .…”

Section: Introductionunclassified

Retalho músculo cutâneo de pálpebra superior para inferior com pedículo medial para correção de ectrópio

Paula¹,

Ono²,

Groth³

et al. 2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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Introdução: O ectrópio se caracteriza por uma eversão da margem palpebral, e é mais comum na pálpebra inferior. O processo de exposição ocular associado a esse quadro pode levar a sequelas graves, como a perda ocular. Muitos retalhos foram propostos para tratar esse quadro. Contudo, a taxa de recorrência pode ser alta, e quando o defeito se localiza na porção medial da pálpebra, ele se torna muito mais desafiador. Por isso, é fundamental que o cirurgião disponha de uma variedade de estratégias cirúrgicas para tratar adequadamente esses casos, definindo, em cada circunstância, qual a melhor técnica a ser adotada, entre as possibilidades disponíveis. O objetivo é apresentar o emprego do retalho miocutâneo de pálpebra superior para inferior, pediculado medialmente, como alternativa no tratamento de três casos de ectrópio Métodos: Tratamento de pálpebra inferior com retalho miocutâneo de pálpebra superior para inferior, pediculado medialmente. Três casos pós-ressecção de lesão oncológica que evoluíram com ectrópio de pálpebra inferior (um deles já recidivado) e que foram trados com retalho miocutâneo de pálpebra superior para inferior, pediculado medialmente; nenhum dos 3 casos apresentou recidiva após essa abordagem proposta. Conclusão: O retalho miocutâneo de pálpebra superior para inferior com pedículo medial demonstrouse uma opção viável, com resultado funcional e estético satisfatório, sem trazer grande prejuízo à área doadora e apresentando pele de cor, espessura e textura adequada à reconstrução da pálpebra inferior.

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Cicatricial iatrogenic lower eyelid malposition in skin cancer surgery: Results of a combined approach

Cited by 13 publications

References 14 publications

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

Efficacy of lateral eyelid‐block excision with canthoplasty and full‐thickness skin grafting in lower eyelid cicatricial ectropion

Retalho músculo cutâneo de pálpebra superior para inferior com pedículo medial para correção de ectrópio

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