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.