Abstract
BACKGROUND:
Since the ocular adnexa contains almost every tissue type, any malignancy may occur in this area, however, the majority are carcinomas, from which basal cell carcinomas (BCC) are the most frequent, followed by; squamous cell carcinoma (SCC), sebaceous gland carcinoma, malignant melanoma. Reconstructing periorbital defects should aim at restoring functional as well as aesthetic improvement (1). Planning of the surgical reconstruction is tempered by several factors including; nature of the defect, integrity of the surrounding tissues, in some cases multiple choices of repair available making planning more complex, as in the medial canthal area (2).
OBJECIVE:
Analyze the most suitable methods of reconstruction of different periorbital defects of different sizes and in different sites.
Analyzing the incidence of recurrence and complications of tumors after surgical excision.
METHODS:
Thirty patients presented with 34 malignant lesion in the periorbital area. The lesions were excised surgically, and the post-excisional defects were classified into five zones in the periorbital area, and were reconstructed using different modalities of reconstruction.
RESULTS:
Out of the 34 lesions, basal-cell carcinoma formed the majority (52.9%), mainly nodular type. Squamous-cell lesions come next in frequency forming (23.5%). Baso-squamous (15%), other tumors (9%). The most presenting symptoms were: ulceration with or without infection (38.2%). Primary closure was done for (26.4%) of cases, same number was reconstructed by STSG. FTSGs formed (17.6%). Local flap used in (23.5%).
CONCLUSION:
In reconstructing periorbital defects; size of the defect, site and state of the surrounding tissues determine the mode of reconstruction. Flaps are superior to grafts in term of lower incidence of complications and aesthetic outcome, whereas grafts remain better to detect early recurrence.
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