[External canthus reconstruction with tarso-conjunctival transposition flap and Hübner's graft]

The external canthus defects with resection of the superior and inferior eyelids external portion remains difficult to treat. The reconstruction has to focus on both the reconstruction of the tarso-conjunctival plan and the musculo-cutaneous plan but has also to treat the disappearance of the external canthus. Usually the tarso-conjunctival plan is reconstructed by a septal transplant, conqual or of palatine mucous membrane. The technique presented here suggests to use two tarso-conjunctival transposition flaps to reconstruct the external canthus and the canthal external ligament. The palpebral defect is then pulled medialy, and is easily reconstructed by a Hübner's graft. The coverage of these tarso-conjunctival flaps and grafts is realized with local cutaneous or musculo-cutaneous flaps. The aim of this reconstruction is to allow a functional and aesthetic reconstruction with respected lid margins with eyelashes. Thanks to this technique, it is possible to reconstruct external canthus defects up to half of the superior and inferior eyelids.