DOI: https://doi.org/10.36347/sjmcr.2026.v14i04.036

Pages: 739-743

Orbital exenteration is a radical surgical procedure indicated for locally advanced palpebro-orbital malignancies, particularly basal cell carcinoma. Although it provides effective oncologic control, it results in significant functional and aesthetic morbidity, making reconstruction of the orbital cavity a major challenge. We conducted a retrospective monocentric study at the Maxillofacial Surgery Department of Mohammed VI University Hospital in Marrakech, including six patients treated between January 2023 and August 2025 for palpebro-orbital basal cell carcinoma. All patients underwent total orbital exenteration followed by delayed reconstruction using a temporalis muscle flap. Clinical, radiological, histopathological data, postoperative outcomes, complications, and aesthetic results were analyzed. The mean age was 68.7 years, with equal sex distribution. Tumors were located in the eyelid or medial canthus in all cases, with multifocal naso-jugal extension in 33.3%. Histologically, all lesions were basal cell carcinomas, predominantly infiltrative forms (50%). Reconstruction was achieved using a temporalis muscle flap, followed by skin grafting in 83.3% of cases. Favorable postoperative evolution was observed in 83.3% of patients. One case (16.7%) of flap necrosis occurred, associated with tumor recurrence at one year. Aesthetic outcomes were considered satisfactory in most patients. Orbital exenteration remains an effective treatment for advanced palpebro-orbital basal cell carcinoma. Reconstruction using the temporalis muscle flap is a reliable and reproducible technique, offering a favorable balance between oncologic safety and aesthetic outcome, particularly in resource-limited settings. Larger prospective studies are needed to validate these findings.