Reconstruction of the temporal canthus.

In the course of tumour excision the entire lateral canthus including the lateral palpebral ligament may have to be removed along with an upper or lower lid. In such cases it is difficult to conceal the defect and restore the function of the eyelids by plastic surgery. A combined advancement rotation flap has proved to be a technically simple method of reconstruction and successful functionally as well as cosmetically. A temporal flap is prepared and advanced medially. By making incision(s) into this flap it is possible to reconstruct both the canthus and the sulcus suprapalpebralis. The lateral tarsal margins are fixed to the periosteum by chromic catgut loops, and with a skin flap there is sufficient support to ensure normal function. An inner lining is provided by mobilising conjunctiva. The advantages and results of this method are discussed.