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A Journal on Dermatology

Journal of Istituto Dermatologico San Gallicano
Official Journal of the Associazione Dermatologi Ospedalieri Italiani - A.D.O.I.
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Esperienze Dermatologiche - DERMATOLOGICAL EXPERIENCES 2009 June;11(2):81-5

language: Italian

The island flap in the repair of inner canthal de-fects

Ascari Raccagni A. 1,2, Russo A. 1, Righini M. G. 1

1 U. O. di Dermatologia, Ospedale “G. B. Morgagni-L. Pierantoni”, Forlì
2 Master in Chirurgia Dermatologica, Clinica Dermatologica, Università di Siena


This report describes a case of inner canthal reconstruction after radical surgery for a voluminous nodular, ulcerated basal cell carcinoma involving the medial commissure of the right eye. In the first stage conducted under local anesthesia, tumor removal resulted in a wide loss of substance of the inner canthus. The tumor extended into the medial portion of both eyelids and penetrated full skin thickness. Histologic study confirmed complete tumor excision. In the second stage conducted in local anesthesia, the defect was corrected with an island flap mobilized from the contiguous region of the nasal saddle. During the procedure the flap was modified so as to increase mobility and adapt its lateral profile to the inner canthal defect and to cover the loss of substance of the eyelids. The technique is simple: after performing local anesthesia, the defect is repaired with skin similar in aspect, thickness and pigmentation to the removed skin. Outcome after surgery was highly satisfactory: both esthetic appearance and eyelid function were restored.

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