DOI: 10.36347/sjmcr.2024.v12i03.035

Pages: 368-371

Introduction: The lower eyelid is a frequent site of basal cell carcinoma (BCC), the excision of which leaves room for loss of substance of varied characteristics which must be reconstructed. We report the case of a patient treated in our training for basal cell carcinoma of the right lower eyelid. Observation: This is a 78-year-old female patient, a farmer, without any particular ATCD, who presents an ulcerative-budding mass of the lower right eyelid measuring 2.5cm in its long axis, painless, and has been evolving slowly for 10 years. A facial CT scan revealed a lesional process infiltrating the eyelid without extending to the endo-orbital structures. A biopsy revealed sclerodermiform and nodular basal cell carcinoma. The patient underwent tumor excision with 1cm margins under general anesthesia, performing a total amputation of the lower eyelid associated with loss of jugal substance. She benefited from reconstruction using palatal fibromucosa for the posterior lamella and Mustardé temporo-jugal advancement-rotation flap for the anterior lamella and cheek. Discussion: Eyelid reconstruction constitutes a real challenge for the surgeon who must meet aesthetic and functional requirements. Several means of repair have been described in the literature. The choice falls to the surgeon who must respect the principles of eyelid reconstruction. This choice depends on the characteristics of the loss of substance and the experience of the surgeon.