Original Article

Surgical excision and reconstruction results on periocular basal cell carcinoma: our clinical experiences - Original Article

  • Dilek Yüksel
  • Evin Singar
  • Burçin Çakir
  • Remzi Kasim
  • Sunay Duman

Received Date: 26.03.2009 Accepted Date: 23.09.2009 Turk J Ophthalmol 2009;39(6):477-484

Purpose: To evaluate our surgical excision and reconstruction techniques and results for patients with basal cell carcinoma (BCC) in the eyelids and periocular region. Methods: We evaluated the surgical excision and reconstruction techniques and results in a retrospective study of 27 patients with BCC, operated between 1999 to 2008 years. Surgical excision was performed at a 5mm distance from the tumor margin. Frozen section (FS) was performed at 6 cases, but it was not performed at 21 patients. For posterior lamella defects occurred after excision, hard palate mucous graft (HPMG) and superior eyelid tarsoconjuctival graft were used. As for anterior lamella defects, different grafts and flaps were used. Results: Due to the detection of residual tumor cells near the surgical border in 1 of 21 patients not controlled by FS, an early revision was performed. In these cases, there was no recurrence in the follow-up. Recurrence was determined in 1 of 6 cases controlled by FS. In this case, twice recurrence was seen previously and tumor was at medial canthal area. In this study, HPMG for reconstruction of posterior lamella defects and superior eyelid skin for reconstruction of anterior lamella defects were used frequently. After reconstruction, lid margin deformity in 2 cases, minimal lower eyelid retraction in 1 case, cutaneous scar in 1 case, minimal symblepharon in 1 case were determined.Satisfactory cosmetic results were achieved in other cases. Conclusion: In this study,no recurrence was reported in a limited number of patients with periocular BCC excised at a 5mm distance from the tumor margin together with the healthy tissue. However, recurrence can rarely be seen in patients with high-risk BCC despite clear borders seen in intraoperative FS. In most of the patients, satisfactory lid repair was acquired with HPMG for reconstruction of posterior lamella defects and superior eyelid skin for reconstruction of anterior lamella defects.

Keywords: Basal cell carcinoma, eyelid reconstructions, frozen section, surgical excision

Full Text (Turkish)