Surgical management of carcinoma of eyelids and periorbital skin.

Abstract

SUMMARY An appraisal of a personal series of 115 unselected and surgically treated cutaneous cancers of palpebral region is presented. Histological confirmation of the diagnosis and adequacy of excision was obtained for all lesions. Seven of the 8 patients with doubtful clearance were successfully treated with further surgery very soon. Complications were few, the incidence of reoperations low, and cosmetic as well as functional results were mostly satisfactory. Tumour recurred in 1 case (087%). Two patients had a poor cosmetic result. Seventy-nine cases (69%) were treated as day cases under local anaesthesia even for major repairs like full-thickness reconstruction of two-thirds of the lower eyelid and repairs with large full-thickness skin grafts of up to 20 x 55 mm by a new simple technique of graft fixation. The use of longer-acting local anaesthetics in oculoplastic surgery is described. Attention is drawn to the dangers of using direct wound closure for repair.

Functional and aesthetic outcomes of eyelid skin grafting in facial nerve palsy

“…The graft is then placed and secured with 6–0 Monocryl (Ethicon, USA) continuous sutures. Grafts are quilted17 using 3–4 central 6–0 Monocryl (Ethicon) mattress sutures between the graft and the recipient bed tied under moderate tension. The harvest site is closed using a 5–0 Monocryl (Ethicon) continuous interlocking suture.…”

Spontaneous reformation of lower eyelid.

“…in addition to involvement of the eyelid margin 1 patient had minimal extension of the tumour just medial to the lacrimal punctum; 1 were also reassured that, if the final result of natural healing was unacceptable, secondary reconstruction(s) would be possible. The patients were given adequate explanation of the commoner methods of full-thickness lower-eyelid reconstruction.…”

The optimal follow-up time for a basal cell carcinoma of the eyelid

“…The histopathologic classification was nodular in 17 cases, morphea type in 8 cases and mixed nodular and morphea type in 6 cases. [13] 14 no Older [14] 157 yes Doxanas [4] 131 yes Tijl [*] 31 yes Mehta [8] 109 no…”

“…Although our patient material is limited, a survey of the literature (Table 1) points in the same direction. Mehta observed one recurrence after 10 months [8]. Mohs described a recurrence rate of 1% in his large series in which extensive and complicated neoplasms were treated [9].…”