Jianliang Yan1, Lunfei Liu, Jiange Qian. 1. Department of Dermatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Abstract
BACKGROUND: Excision of upper eyelid skin cancer often leads to moderate to large defect. Numerous procedures are available to reconstruct such defects, and the reconstructive path chosen should be individualized for each patient. The aim of the reconstruction is a movable eyelid, perfect corneal protection, good aesthetic quality, and acceptable sequelae at the donor site. The purpose of this paper was to present a unique one-stage eyelid reconstruction procedure. METHODS: A 79-year-old male suffered from a skin carcinoma on his left medial canthus, which also involved medial tarsal palate of the upper eyelid. The carcinoma was excised by Mohs micrographic surgery, resulting in a 24 × 10 mm tissue defect on the upper eyelid and medial canthus. A tarsoconjunctival flap pedicled superiorly with the levator aponeurosis, Müller's muscle, and conjunctiva, was designed to reconstruct the posterior lamellar defect. The anterior lamellar defect was repaired with two local skin flaps. RESULTS: The tarsoconjunctival flap and skin flaps survived well. At the third month postoperative visit, the patient was symptom free, and there was no donor site morbidity at the site where tarsus was taken or at the skin flap donor sites. Complete eyelid closure was maintained. CONCLUSIONS: Reconstruction of moderate to large upper eyelid defects with the similar one-stage procedure is recommended.
BACKGROUND: Excision of upper eyelid skin cancer often leads to moderate to large defect. Numerous procedures are available to reconstruct such defects, and the reconstructive path chosen should be individualized for each patient. The aim of the reconstruction is a movable eyelid, perfect corneal protection, good aesthetic quality, and acceptable sequelae at the donor site. The purpose of this paper was to present a unique one-stage eyelid reconstruction procedure. METHODS: A 79-year-old male suffered from a skin carcinoma on his left medial canthus, which also involved medial tarsal palate of the upper eyelid. The carcinoma was excised by Mohs micrographic surgery, resulting in a 24 × 10 mm tissue defect on the upper eyelid and medial canthus. A tarsoconjunctival flap pedicled superiorly with the levator aponeurosis, Müller's muscle, and conjunctiva, was designed to reconstruct the posterior lamellar defect. The anterior lamellar defect was repaired with two local skin flaps. RESULTS: The tarsoconjunctival flap and skin flaps survived well. At the third month postoperative visit, the patient was symptom free, and there was no donor site morbidity at the site where tarsus was taken or at the skin flap donor sites. Complete eyelid closure was maintained. CONCLUSIONS: Reconstruction of moderate to large upper eyelid defects with the similar one-stage procedure is recommended.