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[Plastic surgery of the eyelids after tumoral excision. Apropos of 299 cases].

Plastic surgery of the peri-orbital area after tumor resection is a special and interesting field of reconstructive surgery. Our experience concerns the surgical treatment of 299 malignant tumors of the skin of the peri-orbital area in 291 patients. Basal cell carcinomas were the most common but we also had 8 squamous cell and 4 mixed carcinomas and 1 malignant melanoma. Among these tumors, 277 were primary and 22 were recurrences: 5 after X-Ray therapy, 9 after surgery elsewhere, 4 after electrocautery and 4 after combined treatments. The lower eyelids and the inner canthus areas were the most frequently involved in our series with relative infrequency in the outer canthus and upper eyelids. We used direct closure and local flaps in the repair of most of our patients, but we also used some full thickness skin grafts by preference for the upper eyelid. Complications consisted of 8 cases of ectropion and 2 flap necroses for which a revision was performed in some cases. Concerning our carcinological results among the 123 patients with one year minimum follow up we noticed 4 recurrences which represents a percentage of 3.2%.