Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Moh’s Micrographic Surgery for periocular carcinomas: Indications and Insights from 15 years of experience
Author: Katya Tambe
ePoster Number: 206,00
Purpose
To summarise 15 years of experience using Mohs micrographic Surgery (MMS) for the excision of periocular carcinomas. To evaluate the indications, contraindications, benefits and drawbacks of using this method of margin controlled tumour excision. To provide practical insights to guide optimal patient selection to improve functional and clinical outcomes.
Methods
This is a summary of a 15 years experience of periocular carcinomas excised by Mohs micrographic Surgery (MMS) performed by dermatology surgeons and reconstructed by oculoplastic surgeons at our institution. The period covers 2010 to 2025. All cases were discussed preoperatively at the weekly Special Skin multidisciplinary MDT to ascertain suitability for the procedure, prior to proceeding with Mohs.
Results
Approximately 1500 cases have been treated by MMS followed by periocular reconstruction over the 15 years. Patients unable to have surgery under local anaesthesia, those with moderate to severe cognitive impairment, very large carcinomas or carcinomas that had breached the orbital septum and entered the orbit were excluded from MMS and under went wide local excision. Most patients required one pass and a few required 3 or more passes for tumour clearance. Reconstruction was done the same day under local anaesthesia or the following day under general anaesthesia.
Conclusion
Mohs Micrographic surgery is a highly effective technique for achieving margin clearance in periocular carcinoma, particularly in the anatomically sensitive areas. Use of adjunctive techniques like mini-Monokas can help preserve the canaliculus. Tissue conservation including sparing of the tarsal plate and lateral canthal angle and in some cases the eyelid margin is achievable with careful surgical planning. However MMS nay be less appropriate for larger tumours, or tumours breaching the orbital septum or in patients with systemic issues such a cognitive impairment where demands of the procedure limit its suitability in our institution.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Katya | Tambe | Nottingham University Hospitals NHS Trust, UK |
| Sandeep | Varma | Nottingham University Hospitals NHS Trust, UK |
| Anand | Patel | Nottingham University Hospitals NHS Trust, UK |
| Ashish | Sharma | Nottingham University Hospitals NHS Trust, UK |
| Prashant | Oberoi | Nottingham University Hospitals NHS Trust, UK |
| Mohamed | Morgan | Nottingham University Hospitals NHS Trust, UK |
Abstract ID: 25-590
