Eyelid reconstruction following excision of cutaneous malignancy

With advancing age, cutaneous malignancy around the eye becomes more prevalent. Different kinds of malignant tumors of the eyelid have features particular to their subtype, and a diagnosis should be obtained before definitive treatment if possible. The aim of treatment is total tumor eradication with the smallest recurrence risk, using the most cost-effective method that is acceptable to the patient. Reconstruction of periocular defects following excision of eyelid malignancy can present difficulties, and various reconstructive procedures can be applied.

The retrospective study carried out has analyzed 173 patients submitted to surgery for skin cancers located in the eyelid region with particular reference to the period January 2005 to January 2012. We analyzed certain data (age, sex, histological types, affected portion of eyelid, incidence recurrence by histological type, incidence recurrent tumors previously treated by surgery [secondary], type of removal, type of reconstruction, and mean time elapsed between the demolitive act and disease recurrence) both individually and in correlation with each other. Multivariate analysis (Cox algorithm) was used to identify those variables that had a clear statistical significance.

Melanoma and lentigo maligna have the highest tendency to relapse (33%), but squamous cell carcinoma has more rapid replicative capacity.

Extensive demolition should always be followed by extensive reconstruction. Even through intervention with an extensive demolition in cases of large tumors in the eyelid and cantus, it has not been possible to avoid the recurrence of the disease. The average time of recurrence when compared with reconstruction varies between 28 (minimum) and 39 months (maximum).