Reconstruction of Full-Thickness Eyelid Defects Following Malignant Tumor Excision: The Retroauricular Flap and Palatal Mucosal Graft.

Abstract

Treatment of malignant periorbital tumors requires radical resection of the tumor, which can result in the creation of major eyelid defects. Reconstruction of such defects with satisfactory restoration of function and aesthetic appearance is difficult. The present patient series describes the satisfactory outcomes achieved with a new surgical approach using a retroauricular flap and palatal mucosal graft. The authors reviewed 19 patients of eyelid defects created upon resection of malignant periorbital tumors between 1994 and 2012. Upon confirmation of the defect size, the eyelid defect was repaired with a palatal mucosal graft. Then a retroauricular flap was prepared at the postauricular region and the flap was used to cover the skin defect. In 1 patient, serious venous congestion of the flap occurred. After emergency surgery, the epidermis of the flap died, but the base of the flap survived. Thus, dermatoplasty was repeated. One-fourth of the flap died in 1 patient with an upper eyelid defect near the inner canthus, and after dressing of the wound, dermoplasty was repeated. No complications occurred in the other 17 patients, and satisfactory results were achieved.Thus, using a retroauricular flap, the authors can obtain good aesthetic results in the reconstruction of eyelids defect including the inner and external canthus. The color and texture of the retroauricular flap are similar to those of the eyelid, and scar contracture has a minimal effect.