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Managing cutaneous melanoma of the eyelid: Evidence from surveillance, epidemiology, and end results (SEER) program

Published:October 16, 2022DOI:https://doi.org/10.1016/j.bjps.2022.10.008
      Ramachandran and Phan's investigation of Mohs Micrographic Surgery (MMS) versus Wide Local Excision (WLE) for T1 stage eyelid melanoma

      Ramachandran V. and Phan K. Mohs micrographic surgery versus wide local excision for eyelid melanoma: analysis of a national database. J Plast Reconstr Aesthet Surg (2022). Accepted (pre-publication).

      has important implications for plastic surgery. The study, based on analysis of Surveillance, Epidemiology, and End Results (SEER) Program data, found comparable overall survival and cancer-specific survival for MMS and WLE at over 5-years median follow-up. The non-inferiority of MMS is a promising result. Despite significant surgical innovation in periorbital reconstruction,
      • Ma T.
      • Xu L.
      • Chen Y.
      • Zhang J.
      • Han X.
      • Jiang L.
      Full-thickness lower eyelid defect reconstruction using a pedicle rotation temporal flap and acellular human dermis graft (Alloderm).
      • Su Z.
      • Fan J.
      • Liu L.
      • et al.
      The application of a retrograde postauricular island flap in reconstructing periorbital region defects.
      • Yano T.
      • Karakawa R.
      • Shibata T.
      • et al.
      Ideal esthetic and functional full-thickness lower eyelid "like with like" reconstruction using a combined Hughes flap and swing skin flap technique.
      the eyelid remains a high-risk site for functional and aesthetic impairments after surgery. Compared to WLE procedures, MMS reduces loss of eyelid tissue, obviates the need for delayed surgical reconstruction, and potentially avoids disruption of intricate adjacent structures. MMS thus has potential to improve efficiency, decrease costs, and even decrease need for complex procedures such as transconjunctival flaps, canthoplasty, or canalicular and lacrimal duct repairs.
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      References

      1. Ramachandran V. and Phan K. Mohs micrographic surgery versus wide local excision for eyelid melanoma: analysis of a national database. J Plast Reconstr Aesthet Surg (2022). Accepted (pre-publication).

        • Ma T.
        • Xu L.
        • Chen Y.
        • Zhang J.
        • Han X.
        • Jiang L.
        Full-thickness lower eyelid defect reconstruction using a pedicle rotation temporal flap and acellular human dermis graft (Alloderm).
        J Plast Reconstr Aesthet Surg. 2022; (May; S1748-6815(22)00291-1)
        • Su Z.
        • Fan J.
        • Liu L.
        • et al.
        The application of a retrograde postauricular island flap in reconstructing periorbital region defects.
        J Plast Reconstr Aesthet Surg. 2022; 75 (Feb): 761-766
        • Yano T.
        • Karakawa R.
        • Shibata T.
        • et al.
        Ideal esthetic and functional full-thickness lower eyelid "like with like" reconstruction using a combined Hughes flap and swing skin flap technique.
        J Plast Reconstr Aesthet Surg. 2021; 74 (Nov): 3015-3021
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