Reconstruction of Medial Canthal Defects

Cutaneous defects of the medial canthus present a frequent challenge for the ophthalmic plastic surgeon. These defects are often the result of malignancy excision by either Mohs micrographic surgery or frozen section control. Repair depends largely on wound depth, size, involved structures, and the individual patient’s milieu. Care must be taken to be sure malignancy has not entered the orbit as the thin tissues of the medial canthus lend it to extension into deeper structures. A detailed knowledge of anatomy and a thorough preoperative discussion are crucial to success. The goals of tumor excision and reconstruction must be outlined with the patient in order of their importance: removal of the malignancy, preservation of function, and cosmesis.