[Reconstruction of complex tissue loss of the medial canthus]

The medial canthus is an anatomic and surgical entity. Reconstruction after cancerological resection is complex. The purpose of this article is to report a reconstruction technique for massive loss of tissue of the medial canthus which was applied in 2 patients with 2 years follow-up. Anatomic reconstruction was achieved. Each element of the canthus was restored: skin using Mustardé temporojugal and frontal flaps, conjunctive using a palatine mucosal graft, lacrimal canal using conjuctivo-rhinostomy, the medial canthal ligament using a fascia lata graft and transnasal canthopexia. Both patients developed an ectropion which required revision surgery. At 2 years, the functional outcome is good. Reconstruction allowed adapted social life and the cancer was controlled successfully.