Medial canthal reconstruction with combined glabellar and orbicularis oculi myocutaneous advancement flaps

Abstract

Medial canthal reconstruction following skin cancer excision presents a challenge to the plastic surgeon because of the complex anatomy and the difficulty in obtaining tissue of the appropriate colour and thickness. Reconstruction with local flaps adjacent to the defect is often the first-choice treatment option. The authors have performed reconstruction with combined glabellar and orbicularis oculi myocutaneous advancement flaps in 12 patients. A glabellar flap that can be divided into two parts was designed and elevated according to the defect in the medial canthal. The glabellar flap was transferred to the medial canthal defect after thinning. The residual area of medial canthal defect, which frequently involves the upper eyelid and inferior eyelid, was closed with an orbicularis oculi myocutaneous advancement flap. Reconstruction employing this procedure was performed on 12 patients with defects after resection of a medial canthal basal cell carcinoma. No recurrence was observed in any of the patients, and satisfactory results, including aesthetic results, were obtained for all patients. This technique can be readily used for relatively large medial canthal defects involving upper/inferior eyelid defects according to the size and shape of the defect. It is also aesthetically pleasing because of the inconspicuous postoperative suture line, which is consistent with the topographic curve.