COSMETIC POSSIBILITIES AND PROBLEMS IN EYELID NEUROFIBROMAS

Neurofibromatosis type 1 (NF1) is an inherited systemic disease with f requent ocular involvement. A typical alteration observed in NF1 is th e eyelid plexiform neurofibroma, often associated with facial homolate ral hypertrophy. In such cases, surgical cosmetic results are rather u nsatisfactory, since plexiform neurofibromas classically show a non-ca psulated mass, with a marked tendency to local recurrence. The techniq ues for a cosmetic attempt are discussed on the basis of a personal se ries of eyelid reconstructions in NF1. The results can be considered s atisfactory in some cases, when the orbital shape is preserved and the eyelid structure has not been excessively altered by the neurofibroma ; in all other cases, the cosmetic outcome is inferior to the patient' s and parents' expectations. The serious problem of recurrence is howe ver a limitation to cosmetic surgery in eyelid neurofibromas.