Case report: Orbital exenteration and Mustarde flap on the same patient at a public hospital in the south of Brazil
Author: Deborah Veras
Base Hospital / Institution: Clinical Hospital UFPR , Curitiba Brazil
ePoster presentation
Abstract ID: 24-484
Purpose
To report a case of Orbital exenteration in the right eye due to conjunctival squamous cell carcinoma and Mustarde flap in the left lower lid due to invasive basal cell carcinoma in one stage surgery.
Methods
We performed the surgery with general anesthesia and we used frozen section analysis of margins intra-operatively to assure complete resection. In the right eye we had spare a portion of the eyelids and it was possible to suture the tissues without a graft or flap. In the left eye, it was not necessary to perform a tarsal graft and the eyelid stayed stable and the sutures were out of tension.
Results
Both carcinomas had a complete resection confirmed after paraffin embedding. The patient healed well and his visual acuity is 20/20 in the left eye. He was referred for facial prosthesis adaptation via the public system and for parotid ultrasound. He is also following up with the head and neck doctors. No metastases have been found so far.
Conclusion
Mohs micrographic surgery is the gold standart for the management of skin cancers, especially in regions where maximal tissue preservation is paramount, such as the periocular region. In our public system we don’t have Mohs surgery, but we can try a complete resection with wide margins and frozen section analysis with good results.
In orbital exenterations skin-muscle flaps raised from as little as half of an eyelid generally allow such direct closure, as we performed in our patient. The Mustarde cheek rotation flap has proved to be an extremely successful and reliable technique for repairing large defects of the lower lid and this technique helped us as well.
In conclusion, many of our patients usually work in the fields and are exposed to the sun for many years. They arrive with very advanced disease in our public system. As we have very long waiting lines, we have to carry out as many procedures as possible within the time available in the operation room. That’s why we performed two major surgeries on the same patient.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Germano | Boff | Clinical Hospital UFPR , Curitiba Brazil |
| Leonardo | Girardi | Clinical Hospital UFPR , Curitiba Brazil |
