|Programm||"Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"|
Eyelid Tumors: Resection and Reconstruction
Riedel K. G.
Tumor resection and eyelid reconstruction follow distinct guide lines of ophthalmic plastic and reconstructive surgery saving both function and aesthetic appearance of the eyelid involved. Skin incisions are made in or parallel to the relaxed skin tension lines. Vertical tension should be avoided and the vascular supply of the eyelid has to be preserved. More than 90% of all malignant lid tumors are basal cell carcinomas including the nodular, the noduloulcerative, and the morpheaform types. Lid tumors with metastatic potential are squamous cell carcinoma, sebaceous carcinoma and malignant melanoma. In cases of unclear dignity of the tumor a biopsy is performed prior to resection. In all patients with large tumors, with tumors within the lid angles, and with recurrent lesions entire tumor resection must be verified by histopathology before the reconstruction is performed. In eyelid tumor surgery there are several techniques to reconstruct the anterior or the posterior lid lamella including the direct wound closure as well as advancement, rotation, or transposition flaps. Split-thickness and full-thickness skin grafts are also used in certain conditions. Presented are well established surgical techniques including the semicircular flap (Tenzel), tarsoconjunctival flap (Hughes), and the use of tarsomarginal grafts.