Basal Cell Carcinoma in Medial Canthal Region (original) (raw)
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Saudi Journal of Ophthalmology, 2013
Purpose: Basal cell carcinoma (BCC) is the most common skin cancer worldwide. BCC represents 90-95% of all malignant eyelid tumors with lower eyelid/medial canthus lesions being more common than lower eyelid/lateral canthus lesions. Although various local flaps have been used for the reconstruction of medial canthus/adjacent eyelid defects, we find the forehead flap to be the most suited for these cases. Materials and methods: We are reporting a clinical series of BCC involving the medial canthus and adjacent medial lower eyelid through a retrospective review of 18 patients who underwent surgical excision of the lesion followed by primary reconstruction using forehead flaps. Patients who underwent reconstruction without forehead flaps were excluded. All cases were Saudis and underwent this type of reconstruction. Indications, results, and complications were reviewed with special emphasis on the acceptance of the obvious forehead donor site scar in Saudi patients. Results: All flaps survived completely Follow-up ranged from 2 to 10 years (mean of 5 years). Tumor recurrence was not seen in any of the patients. Functionally, there was no ectropion and the eyelid margin was well aligned and stable. However, epiphora was evident since lacrimal system reconstruction was not performed. Conclusion: We are presenting the first Saudi series of large medical canthus/lower eyelid defects that underwent reconstruction using forehead flaps. The outcome was satisfactory and there were no cases of tumor recurrence. The only disadvantage is the donor scar which seems to be acceptable in the Saudi population because of their traditional head cover.
Management of Basal Cell Carcinoma of Face
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Basal Cell Carcinoma is a locally invasive, slowly spreading tumour which rarely metastasises, arising in the epidermis or hair follicles, the cells usually resembling the basal cells of the epidermis. The Basal Cell Carcinoma in North Indian population usually involves head and neck region. The management of Basal Cell Carcinoma of face requires excision of lesion with healthy margins and resurfacing the defect by split skin graft/ flap coverage. Aims and Objectives: 1. To evaluate the epidemiology of Basal Cell Carcinoma of face. 2. To evaluate various modalities of coverage of the defect following surgical excision of Basal Cell Carcinoma of face. MATERIALS AND METHODS This case series was conducted in the Department of Surgery, Govt. Medical College Jammu, J and K, India and included 50 patients having been diagnosed with Basal Cell Carcinoma of face (histopathology proven) admitted in surgery ward from November 2015 to October 2017 (Prospective study). All patients underwent surgical excision with a 5 mm healthy margin followed by reconstruction either by skin graft (12%) or flap coverage (88%). RESULTS Majority of the patients had restoration of anatomy and normal function after reconstructive procedures with colour and contour matching of that of the recipient site. No major complication was encountered in any of the patients. CONCLUSION Basal Cell Carcinoma is treated with surgical excision followed by adequate coverage of the defect by a modality which should not only be functionally adequate, but also aesthetically appealing. Flaps are a versatile modality of reconstruction with the choice of flap being governed by the site and size of the defect post tumour excision.
Modified cervicofacial flap for temporal region reconstruction post basal cell carcinoma excision
2021
Background: Cervicofacial flap is considered to be the main choice for reconstruction of large defect in skin malignancies at head and neck such as basal cell carcinoma. Cervicofacial flap has a high successfull rate, due to the excellent vascularization, also the suitable matching in colour, thickness and texture. Purpose: To find out the result of reconstruction with modified cervicofacial flap after wide excision of basal cell carcinoma. Case report: A case of a 54-year-old-woman with basal cell carcinoma of the skin at right temporal region. Reconstruction of the temporal area was performed using a modified cervicofacial flap and followed by adjuvant radiotherapy, which resulted in a good outcome. Clinical Question: Is modified cervicofacial flap, the appropriate technique for defect reconstruction of post excision basal cell carcinoma at temporal region? Review method: Evidence based literature study of the procedure and outcome after reconstruction with modified cervicofacial ...
Maxillofacial reconstruction following the excision of basal cell carcinoma: Case report
Introduction Local flaps have been commonly used in the reconstruction of small facial defects left after excision of primary tumours. However, larger defects often present a surgical difficulty and may necessitate free flaps. However, in the repair of such large defects, multiple local flaps may prove to be a viable and satisfactory alternative. Case Report We resected a lesion 4*5cm size, quadrilateral in shape, on the left ala of the nose, extending on to the dorsum, left infra orbital and malar regions along with a wide margin of normal tissue. Reconstruction of the resultant defect was done using multiple local flaps namely the paramedia n forehead flap, the lateral cheek rotation flap & the platysma myocutaneous flap. Discussion Facial defects can be managed with the correct choice of local flap. Local flaps being easy to harvest and handle, provide good results due to good matching of the skin in terms of colour, texture, and thickness. Conclusion Our case, throws light, on t...
A novel technique for full thickness medial canthal reconstruction; playing with broken lines
Journal of Current Ophthalmology, 2016
Purpose: To introduce a new modification of transposition flap technique for reconstruction of the medial canthal region. Methods: This prospective study included 58 patients with the full thickness involvement of both upper and lower lid in the medial canthal area. Reconstruction of posterior lamella was performed by utilizing periosteal flaps and tarsoconjunctival grafts, and anterior lamellar reconstruction was performed using transposition of multiple full-thickness skin flaps, a modified form of rhomboid flap technique. Post-surgical outcomes, advantages, and drawbacks of this technique are discussed. Results: Between 2010 and 2014, 58 patients with basal cell carcinoma (BCC), proven by histopathologic study, underwent medial canthal reconstruction. The mean age was 72.8 ± 8.3 years. In 30 patients, the lacrimal apparatus was excised, and periosteal flaps or tarsoconjunctival grafts were prepared to reconstruct the posterior lamella. Anterior lamellar reconstruction was performed in all patients, and the mean number of transposition flaps was 3.63 in addition to the blepharoplasty flap. Patients were followed for 24 months. None of the patients developed flap necrosis or other intraoperative and postoperative complications, with acceptable aesthetic and functional outcomes. Conclusion: Full-thickness reconstruction of the medial canthal area by utilizing periosteal flaps and modified transposition flap technique all in one session can be considered an alternative method in medial canthal reconstruction, with acceptable functional and aesthetic outcomes.
Large full thickness medial canthal reconstruction: a report of two cases and review of literature
2012
The reconstruction of the upper eyelid with medial canthal involvement post extensive removal of malignant tumour remains a challenge. Proper eyelid reconstruction is necessary to re-establish anatomic integrity, restoration of its functions and to maintain the best cosmetic appearance. These case reports illustrate an alternative reconstructive technique for large upper eyelid full thickness defect with medial canthal involvement. Two cases of upper eyelid tumours involving medial canthal region underwent staged reconstruction by glabellar flap advancement and reconstruction of the posterior lamellar with autologous graft using buccal mucosa and ear cartilage. The posterior lamellar graft and flap survived without any complication except for mild eyelid margin notching in one of the two cases. The staged reconstruction with glabellar flap advancement provides adequate defect coverage, excellent blood supply, maintains eyebrow contour and function of the eyelid. The flap also perfec...
V-Y Nasolabial Flap for Reconstruction after Basal Cell Carcinoma Excision
Cermin Dunia Kedokteran
Background: Basal cell carcinoma (BCC) is the most common malignancy worldwide.1 It is usually found in older populations, particularly those exposed to ultraviolet radiation. It is almost always curable when detected and treated early. Surgery remains the cornerstone of BCC treatment; but standard excision results in defects requiring reconstruction. For smaller defects, the V-Y flap is a popular option due to its advantages. Case : A 33 year-old male with a blackened lesion on the left vermillion border of the upper lip with a diameter of 2 cm since 3 months, suspected as basal cell carcinoma. The patient underwent wide excision and the defect was reconstructed using a V-Y flap. Conclusion : Wide local excision is a treatment of choice for BCC to ensure clear margins, preventing further local recurrence and distant metastasis. V-Y advancement flap is preferable for the reconstruction of small to medium size facial defects with less scarring and better aesthetic results.Latar belak...
International journal of health sciences
Background: The incidence of basal cell carcinoma(bcc) involving face is on rise. One of the most promising therapies to this tumour is excision, which leaves a defect that has to be reconstructed in a way that would bring the best possible aesthetic and functional outcome. Aesthetically face is classified into many subunits, each contributing cumulatively to the final appearance of face. Reconstructing these subunits after the excision of bcc to impart a near normal appearance is a very challenging task. The outcome depends on various aspects like the skin type, photodamage , the subunit involved and the type of reconstruction . Aim: This study aims to assess the effect of skin type , photodamage, the site of bcc and the type of reconstruction on the aesthetic outcome through modified Vancouver scar scale scoring system. Material and methods : A prospective study was conducted on 53 patients with facial basal cell carcinoma from February 2020 to February 2022. Patients were clas...