Hospital de Manises, Department of Oculoplastics, Valencia, Spain
Fisabio-oftalmología Médica Department of Oculoplastics, Valencia, Spain
Turk J Ophthalmol. 2021 Apr 29;51(2):118-122. doi: 10.4274/tjo.galenos.2020.04641.
The goals of periorbital region reconstruction are to obtain both functional and esthetic results. Medial canthus is the second most common periorbital location for basal cell carcinoma. If left untreated, it is locally destructive but rarely metastasizes. Incompletely resected medial canthal tumors recur or penetrate along the lacrimal path and expand to wider lesions. A safety margin is necessary to ensure a complete lesion resection. Since it was introduced in 1941, Mohs surgery has been promoted as an efficient method of dealing with infiltrative periorbital skin tumors. It has been shown to have high rates of complete cancer removal during surgery, minimizing the amount of normal tissue loss and securing better functional and cosmetic outcomes. Due to its concave contour and convergence of skin units with variable thickness, texture and mobility, reconstruction of the medial canthal region (MCR) remains challenging. Reconstructive methods such as free full-thickness skin grafts and glabellar flaps have been used alone or in combination with other techniques. The concavity of the canthus must be achieved, but the maintenance of the normal contour and symmetry of the surrounding tissue is critical. The glabellar flap (GF) is a triangular advancement flap that adequately restores the volume in deeper defects, guaranteeing sufficient vascular support without complex or undesirable scars. We present two cases of basal cell carcinoma affecting the MCR that was successfully reconstructed using a GF alone in one case and together with a cheek advancement flap in the second one. In both cases, tumor excision was performed using Mohs surgery.
眼眶区域重建的目的是获得功能和美观的效果。内眦是基底细胞癌第二常见的眶周位置。如果不治疗，它具有局部破坏性，但很少转移。未完全切除的内眦肿瘤会沿着泪道复发或穿透，并扩展为更广泛的病变。为了确保完整的病变切除，需要有安全的边缘。自 1941 年引入以来，Mohs 手术一直被推广为处理浸润性眶周皮肤肿瘤的有效方法。它已被证明在手术中有很高的完全清除癌症的比率，最大限度地减少正常组织的损失，并确保更好的功能和美容效果。由于内眦的凹形轮廓和皮肤单位的收敛性，具有不同的厚度、质地和可移动性，内眦区域（MCR）的重建仍然具有挑战性。单独使用或结合其他技术使用游离全厚皮片和眉间皮瓣等重建方法。必须达到内眦的凹陷，但周围组织的正常轮廓和对称性的保持至关重要。眉间皮瓣（GF）是一种三角形推进皮瓣，可充分恢复深部缺损的体积，保证足够的血管支持，而不会形成复杂或不理想的疤痕。我们提出了两例基底细胞癌影响 MCR 的病例，一例单独使用 GF 成功重建，另一例与颊推进皮瓣联合使用。在这两种情况下，肿瘤切除均采用 Mohs 手术。
