Reconstruction of periocular defects with rhomboid flap: Surgical results

Abstract

Purpose: To review the surgical results in patients who underwent an eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision.Material and Method: This study included 18 patients who underwent eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision. The patient charts were reviewed for topographic data, tumor features, surgical technique, and postoperative results.Results: The mean age of the patients (10 women, 8 men) was 58 years (age range: 22-78 years). The lesion was located in the inferior periorbital-malar area in 8 patients, in the medial canthal area in 8 patients and in the lateral periorbital area in 2 patients. Mean tumor diameter was 8.9 mm (range: 5-13.5 mm). Rhomboid flap was used alone in 14 patients (78%) and in combination with nazojugal advanced flap and semicircular flap in 2 patients (11%) each. The skin defect could be closed primarily in all patients, except one. A secondary surgical intervention was required for ectropion and pyogenic granuloma excision in 1 patient each. The aesthetic outcome was satisfactory in all patients. Mean follow-up time was 23 months (range: 2-64 months).Discussion: Rhomboid flap can be used for medial canthal and periorbital eyelid reconstruction after tumor excision. This flap technique can be combined with other reconstruction methods for large defects. After surgery, aesthetic and functional results are satisfactory in most patients, whereas surgical complications and need for a secondary surgery are rare.