Surgical reconstruction of eyelids

Tumors of the eyelid region are a special entity within the tumors of head and neck. Their early recognition and histologic classification helps to avoid extensive and destructive surgery, which is particularly challenging with regard to the surgical repair of those defects. In 58% of the patients with eyelid tumors treated at Fachklinik Hornheide between 2002 and 2006, a malignant neoplasia was diagnosed. In eyelid surgery, particular principles need to be observed. Provided those guidelines are strictly observed, even extensive defects of the upper or lower eyelid can be repaired in an aesthetically acceptable manner. When reconstructing a lower eyelid, not only restoration of the original structure of the margin of the lower eyelid including the ciliary edge is aimed at but also stabilization of the eyelid especially in reconstruction of the lateral angle of the eye. Static reconstruction is not sufficient in many cases with extensive defects of the upper eyelid. It is necessary not only to replace skin, mucosa, and tarsus, but also to restore mobility and function of the upper eyelid to enable complete eyelid closure to protect the cornea. In the current study, the experience with various techniques of eyelid reconstruction and their functional and aesthetic implications are presented and discussed.