*Division of Oculofacial Plastic and Orbital Surgery, and †Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; ‡Departments of Ophthalmology, University of California San Francisco (UCSF), Stanford University, and §Departments of Ophthalmology, California Pacific Medical Center, San Francisco, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2014 Jan-Feb;30(1):15-9. doi: 10.1097/IOP.0b013e3182a74f21.
To determine the tumor control rate of basal cell carcinoma (BCC) of the eyelid margin managed by full-thickness eyelid resection with en-face frozen section-controlled margins and primary reconstruction of the defect.
This is a retrospective, consecutive, noncomparative, longitudinal interventional case series from a single institution. A review of medical records of all patients with BCC involving the eyelid margin treated by full-thickness en-face frozen section histopathology between June 1997 and June 2011 was conducted. All cases were managed with gross full-thickness resection of the eyelid margin tumor with subsequent reconstruction. Intraoperative frozen section histopathology was performed on additional 1-mm thick medial, lateral, and inferior/superior specimens in a full-thickness en-face fashion. The main outcome measure was rate of recurrence over the follow-up period. Additional data collected included patient demographics, lesion site and size, histopathology, reconstructive technique, and postoperative complications.
The review resulted in a total of 74 patients with 77 lesions. Of these, 45 lesions had a minimum 5-year follow up. Those cases that involved the lacrimal system were excluded resulting in a total of 43 cases for analysis, which had a mean follow up of 6.4 years (range, 5.0-13.0). Three cases (6.9%) represented a recurrent BCC, while all other cases were primary BCCs. The histopathological subtypes included nodular (65.1%), infiltrative (18.6%), and superficial (16.3%). There were no cases of recurrence (100% cure rate) over the follow-up period. Most defects (88.4%) were reconstructed by direct closure or a temporal rotation flap. The only complication noted was the development of a hypertrophic scar in 1 patient that resolved with conservative management. In the total series of 77 lesions, the mean follow-up period was 4.5 years (range, 0.5-13.0). One recurrence (1.3%) was detected after 1.1 years for an infiltrative BCC measuring 10.0 mm in diameter that involved the lacrimal system.
Eyelid margin BCC can be managed effectively with full-thickness en-face frozen section-controlled excision and primary reconstruction of the defect. The high cure rate compares favorably with other excision techniques such as Mohs micrographic surgery, with the advantages of a single operation and excellent reconstructive result.
确定通过全层眼睑切除术和面向面部的冷冻切片控制边缘以及缺损的原发性重建来治疗眼睑边缘基底细胞癌（BCC）的肿瘤控制率。
这是一项来自单个机构的回顾性、连续、非对照、纵向干预性病例系列研究。对 1997 年 6 月至 2011 年 6 月期间接受全层面向面部冷冻切片组织病理学治疗的所有涉及眼睑边缘的 BCC 患者的病历进行了回顾。所有病例均采用全层眼睑边缘肿瘤的大体全层切除术进行治疗，随后进行重建。在全层面向面部的方式下，对内侧、外侧和下/上 1 毫米厚的额外标本进行了术中冷冻切片组织病理学检查。主要观察指标为随访期间的复发率。收集的其他数据包括患者人口统计学、病变部位和大小、组织病理学、重建技术和术后并发症。
该回顾共纳入 74 例 77 处病变。其中，45 处病变有至少 5 年的随访。由于涉及泪器系统，排除了这些病例，最终共有 43 例用于分析，平均随访 6.4 年（范围为 5.0-13.0 年）。3 例（6.9%）为复发性 BCC，而所有其他病例均为原发性 BCC。组织病理学亚型包括结节性（65.1%）、浸润性（18.6%）和浅表性（16.3%）。在随访期间无复发病例（100%治愈率）。大多数缺陷（88.4%）通过直接闭合或颞部旋转皮瓣进行重建。唯一的并发症是 1 例患者出现肥厚性瘢痕，经保守治疗后得到缓解。在 77 处病变的总系列中，平均随访时间为 4.5 年（范围为 0.5-13.0 年）。1 例浸润性 BCC 直径为 10.0 毫米，累及泪器系统，在 1.1 年后检测到 1 例复发（1.3%）。
全层面向面部冷冻切片控制切除和缺损的原发性重建可有效治疗眼睑边缘 BCC。高治愈率与 Mohs 显微外科手术等其他切除技术相比具有优势，其优点是单次手术和出色的重建效果。
