Overview
The report covers a pediatric patient with a congenital nevus (birthmark) of the lower eyelid who developed scar-related ectropion after two local excisions at another hospital. On referral, the authors reconstructed the eyelid using a temporally based orbicularis oculi myocutaneous (OOMC) flap, a flap of muscle and skin taken from the side toward the temple and rotated into place to pull the lid back up and give it structural support.
Findings
- Patient: pediatric, congenital melanocytic nevus of the lower eyelid, cicatricial ectropion after 2 prior excisions elsewhere.
- Reconstruction: temporally based orbicularis oculi myocutaneous flap, designed along the lateral canthus-temporal direction for upward traction and muscular support.
- Flap gave adequate tissue thickness and a color match resembling the lower eyelid.
- Superior flap border aligned with the lower lid margin; inferior border curved to redistribute tension and reduce recurrence risk.
- Postoperatively, flap blood supply was stable and the ectropion was corrected.
- On follow-up, eyelid margin position remained stable with satisfactory symmetry.
What it means for a patient
- When a child's lower eyelid pulls down and out after mole removal surgery, a flap of nearby muscle and skin can restructure and support the lid.
- In this case, the repair held its position and looked symmetric on follow-up, with no report of recurrence.
- This is one patient's case, so it does not establish how often this repair succeeds across many children.
Why this paper matters
It describes a specific flap design, anchored along the outer corner of the eye toward the temple, for repairing scar-related lower eyelid ectropion following prior lesion excision in a child.
Terms
- Ectropion: the eyelid margin turning outward, away from the eye.
- Cicatricial: caused by scar tissue.
- Orbicularis oculi myocutaneous flap: a flap combining the eyelid-closing muscle and overlying skin, moved together with its blood supply.
- Lateral canthus: the outer corner of the eye, toward the temple.
- Congenital melanocytic nevus: a birthmark made of pigment-producing cells, present from birth.