Lower Eyelid Orbicularis Oculi Myocutaneous Flap: A Feasible Technique for Full Thickness Upper Eyelid Reconstruction

Basal cell carcinoma (BCC) is the most frequent malignant eyelid tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma and malignant melanoma. These eyelid malignancies represent main reason for eyelid reconstruction in ophthalmoplastic surgery which can be challenging. Lower eyelid orbicularis oculi myocutaneous flap was used for reconstructive purpose in four consecutive patients with a full thickness upper eyelid BCC. Digital photographs were taken at baseline, 1 month, 3 and 6 months after surgery to assess clinical outcome. Four patients underwent full thickness upper eyelid reconstruction with a lower eyelid orbicularis oculi myocutaneous flap after BCC radical resection with 3-mm safe margins. Histological subtypes showed tumor complete excision in all cases. No patient showed local recurrence at a mean 12 months follow-up. The high functional-esthetical success rate of the modified Hughes procedure corresponds with the beneficial results, which have been reported in previous publications. None of the treated patients complained about forced temporary closure of eyelid. In all four cases treated, aesthetic and functional outcome were satisfactory.