Reconstruction of lower eyelid defects after the  excision of basal cell carcinoma

Bejinariu, Catalin Gheorghe; Popescu, Siramona; Dragosloveanu, Christiana Diana Maria; Marinescu, Silviu Adrian

doi:10.22336/rjo.2020.64

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…The size of the defect left after the excision was less than one-third of the eyelid margin, which is considered a small defect. Since we also excised a part of the tarsus which needed to be reconstructed to keep the structural integrity of the eyelid -the auricular cartilage which we harvested from the left ear was then placed instead of the excised tarsal part and sutured [3], [4], [5], [6]. Primary closure is usually employed when one-third or less of the eyelid margin is involved -so all of these facts shaped our treatment approach -surgical excision and placement of a cartilage graft, followed by a lateral canthotomy, cantholysis, and local tissue advancement.…”

Section: Discussionmentioning

confidence: 99%

Aesthetic Palpebral Reconstruction Following the Excision of Basal Cell Carcinoma (BCC): A Case Report

Tudzarova-Gjorgova,

Selchanec,

Spasova

et al. 2024

Open Access Maced J Med Sci

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BACKGROUND: Basal cell carcinoma (BCC) is the most common skin malignancy, and when considering its predilection for the face – it is most commonly found on the eyelids. CASE PRESENTATION: In our patient’s case, the BCC was located on the left lower eyelid exemplifying the classic macroscopic appearance of a nodular basalioma. We took into account all of the patient’s variables (particularly the lesion’s difficult location) to choose the best surgical approach for excision of the tumor, as well as the reconstructive strategy that would result in the most functional and aesthetic outcome. CONCLUSION: In this report, we present a case of our patient with BCC on the lower eyelid, our surgical method for excision and palpebral reconstruction using an autologous auricular cartilage graft, and the final outcome, which we consider was the best option for the patient in question.

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Section: Discussionmentioning

confidence: 99%

Aesthetic Palpebral Reconstruction Following the Excision of Basal Cell Carcinoma (BCC): A Case Report

Tudzarova-Gjorgova,

Selchanec,

Spasova

et al. 2024

Open Access Maced J Med Sci

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“…It typically involved an upper lid musculocutaneous flap and a chondromucosal alar graft. Bejinariu et al (57) performed a nasal chondral-mucosal graft from alar (Texier procedure), triangular, or septal nasal cartilages to reconstruct a series of lower eyelids with a tissue loss of more than half. Cristofari et al (56) evaluated its feasibility for lower eyelid defects between 50% and 75% and those longer than 75% with a chondromucosal nasal septal graft.…”

Section: Nasal Chondromucosal Graftmentioning

confidence: 99%

Posterior lamella substitutes in full-thickness eyelid reconstruction: a narrative review

Guo¹,

Gao²,

Ma³

et al. 2023

Front Oral Maxillofac Med

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Background and Objective: Severe full-thickness eyelid defects seriously endanger the health and beauty of the ocular surface. It is the most challenging field of oculoplastic and reconstructive surgery to reconstruct eyelid's natural appearance and function, in which the posterior eyelid lamella plays an essential role. Without enough substitute support in eyelids suffered sizeable posterior lamella defects, various complications may occur, e.g., entropion, ectropion, incomplete eyelid closure, corneal irritation, keratitis, corneal ulcers, and even vision loss, leading to failure of eyelid reconstruction. This manuscript aimed to summarize recent advances in posterior eyelid lamella substitutes and summarize the types, advantages, and disadvantages of the present posterior lamella substitutes in full-thickness eyelid reconstruction.Methods: A literature search was conducted in the PubMed database to identify relevant publications using the search algorithm "eyelid reconstruction". The full-text publication reports about posterior substitutes from January 2016 to April 2021 in English were selected and reviewed. We also screened relevant research missed in this search algorithm from the reference lists of specific full-text papers.

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“…The primary goal of the surgical procedure is to restore the function and aesthetics of the lower eyelid and the surrounding periocular area while minimizing surgical complications. Ensuring globe protection, normal vision, proper eyelid positioning, and lateral canthal stability are fundamental 1–12 …”

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confidence: 99%

“…In contrast, various surgical techniques can be used for defects involving 50% to 75% of the horizontal length of the medial and central lower eyelid. These techniques range from 1- and 2-stage methods to combined approaches involving both flap and free grafting 1–12 …”

mentioning

confidence: 99%

Modified Mustardé and Superolateral Periosteal Flaps for Full-Thickness Defects of Medial and Central Lower Eyelid

Ongkasuwan

2024

Ann Plast Surg

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Background Reconstructing full-thickness defects involving 50% to 75% of the horizontal length of the lower eyelid after medial and central full-thickness block resection can be challenging. As a disadvanatge, 1-stage reconstructions may require a free graft reconstruction of the posterior lamella. In addition, 2-stage reconstructions are associated with several complications, including erythema, and the eye must be temporarily closed after surgery. Methods The present study describes a single-surgeon retrospective case series. Five patients diagnosed with basal cell carcinoma underwent wide full-thickness block resection with optimal excision margins (3–5 mm). Subsequently, 1-stage reconstruction was performed using the modified Mustardé flap, incised using the transconjunctival approach. This flap comprised the skin, muscle, tarsus, and conjunctival flap raised from the lateral canthus through a lateral cantholysis procedure, and then extended to the lateral cheek. The flap was medially transposed to cover the medial and central lower eyelid defect. The superolateral periosteal flap was harvested from the superolateral orbital rim attached to the lateral border of the tarsus of the modified Mustardé flap. The lateral forniceal conjunctiva was released from the retractor and advanced superiorly to cover the inner surface. Results The study included 3 men and 2 women, with a mean age of 71 years (range, 62–90 years). Histological evaluations confirmed tumor-free margins in all cases. The average follow-up duration was 20 months (6–60 months), with no tumor recurrence. None of the patients developed long-term complications, such as ectropion, entropion, lagophthalmos, trichiasis, symblepharon, erythema, wound dehiscence, or flap necrosis. All patients had minimal scarring, and no secondary surgical interventions were necessary. Conclusions This case series demonstrates the efficacy of the combined modified Mustardé and superolateral periosteal flaps in 1-stage reconstruction of full-thickness defects involving 50% to 75% of the horizontal length of the medial and central lower eyelid without compromising functional and aesthetic outcomes.

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Reconstruction of lower eyelid defects after the excision of basal cell carcinoma

Cited by 4 publications

References 12 publications

Aesthetic Palpebral Reconstruction Following the Excision of Basal Cell Carcinoma (BCC): A Case Report

Aesthetic Palpebral Reconstruction Following the Excision of Basal Cell Carcinoma (BCC): A Case Report

Posterior lamella substitutes in full-thickness eyelid reconstruction: a narrative review

Modified Mustardé and Superolateral Periosteal Flaps for Full-Thickness Defects of Medial and Central Lower Eyelid

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