Reconstruction of Medial Canthal and Lower Lid Defect using Orbicularis Muscle Mobilization

ABSTRACT

PURPOSE: Radiation therapy after radical excision of malignant tumor causes delayed wound healing. We reconstructed successfully medial canthal area and lower lid defect including lacrimal bone which developed after radical excision and radiation therapy of lacrimal sac tumor with transpositional orbicularis muscle flap. METHODS: A 64-year-old male patient visited our clinic for right medial canthal and lower lid defect including lacrimal sac, lacrimal bone, and ethmoid bone which had developed 5 years before due to radical tumor excision and postoperative radiation therapy. RESULTS: At one-year follow-up, the shape and the function of the eyelid showed good results. CONCLUSION: Facial bony defects after radical excision of malignant tumor may cause as well loss of compartmentation between orbit, cranial fossa and nasal cavity as aesthetic problems. This loss may cause delayed wound healing and spread of infection. Orbicularis oculi muscle mobilization can be used in eyelid and periorbital reconstruction including difficult wound repair. This technique can enhance the blood supply to the reconstructed area and allow healing which might not be obtained otherwise.