Reconstruction of medial canthal eyelid tumors - Procedures, problems, andresults

Background. Histologically controlled excision of medial canthal eyelid tum ors often creates large skin defects,which may be closed by various reconst ruction techniques. Patients and methods. To obtain information about indications for surgery, complications, and esthetic and functional results we analyzed 39 of our pa tients who underwent surgery in this area between August of 1995 and Januar y 1998. Results. Four small defects were closed primarily. A free full-thickness sk in graft was used in 15 patients with a medium-sized defect, and 18 patient s with large defects were handled by a local rotation or transposition flap . Granulation was left to occur spontaneously in two patients in poor gener al health. No tumor recurrences were seen. The functional and esthetic resu lts were good. After 3 months free transplants and rotational flaps had hea led in well. Increased scarring with mild medial ectropion was seen in five patients with rotation flaps. Patients who were left to spontaneous granul ation required a more intensive and longer local treatment. Conclusions. For the reconstruction of medial canthal defects after tumor e xcision, free skin transplants were used for small to medium, and rotation flaps for large defects. These are successful procedures with good function al and esthetic results. Spontaneous granulation is an acceptable therapeut ic alternative for patients in poor general health.