Surgical Techniques for Eyelid Tumors

Description

Tumors of the eyelids may be benign cysts, inflammations (stye’s), or malignant tumors (skin cancers). The most common type of eyelid cancer is basal cell carcinoma. Most basal cell carcinomas can be removed with surgery. If left untreated, these tumors can grow around the eye and into the orbit, sinuses and brain. Other eyelid cancers include squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma. Together, these tumors make up the remaining 10% of eyelid malignancies.

Treatment

A simple biopsy can determine if your eyelid tumor is malignant. Then, malignant tumors are completely removed and the eyelid is repaired using plastic surgery techniques. Additional cryotherapy (freezing-therapy) and radiation are sometimes required after surgery.

A Typical Work-Up for a Suspected Malignant Eyelid Tumor

  • Biopsy
  • Medical Work-up (as indicated)
  • Surgery and/or Radiotherapy of Tumor and Margins
  • Reconstruction

Surgery for Eyelid Tumors

  • General: The goal should be total removal of the cancer. This usually involves primary excision with either frozen section control or Moh’s technique.
  • Small tumors are usually removed by pentagonal wedge resection.
  • Medium-sized tumors often require reconstruction with transpositional flaps (Tenzel, Mustarde, Glabellar).
  • Large-tumor resections are typically reconstructed with Hughes, Hewes, or Cutler-Beard Techniques.

References

  1. Hughes WL. New method for rebuilding a lower lid: Report of a case. The Archives of Ophthalmology 17:1008-1017, 1937.
  2.  Hewes EH, Sullivan JH, Beard C. Lower eyelid reconstruction by tarsal transposition. American Journal of Ophthalmology 85:1164-1169, 1978.
  3. Cutler NL, Beard C. A method for partial and total upper lid reconstruction. American Journal of Ophthalmology 39:1-7, 1955.
  4. Tenzel RR, Stewart WB. Eyelid reconstruction by the semicircle flap technique. Ophthalmology 85:1164-1169, 1978.
  5. Harrington JN. Reconstruction of the medial canthus by spontaneous granulation (laissez-faire): A review. Annals Ophthalmology 14:956-960, 1982.

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