McGraw Dahlgaard (bakerbow29)

To describe how a vertical lid split helps excision and reconstruction of conjunctival tumors. All patients with a limited view of conjunctival tumors involving the fornices underwent a vertical lid split procedure to improve access during resection and reconstruction. There were 11 cases where vertical lid splits were performed to assist excision and reconstruction of conjunctival tumors on patients between 2015 and 2019. There were 4 male and 7 female patients, 50-85 years of age, mean age 67.2 years. Four patients had invasive malignant melanoma, 2 melanoma in situ, 3 invasive squamous cell carcinoma, and 2 squamous cell carcinoma in situ. The authors have had no local reoccurrences in 9 patients (follow-up 8-54 months, mean 18 months). One patient's deep margins were involved and proceeded to exenteration, and 1 patient died from liver metastases. A vertical lid split incision of either or both eyelids, well away from the visible tumor edge splays the lid open allowing the whole conjunctival surface to be stretched out and viewed as a single flat sheet. This aids excision and reconstruction of the tumor, potentially reducing the risk of seeding and simplifying the reconstruction. A vertical lid split incision of either or both eyelids, well away from the visible tumor edge splays the lid open allowing the whole conjunctival surface to be stretched out and viewed as a single flat sheet. This aids excision and reconstruction of the tumor, potentially reducing the risk of seeding and simplifying the reconstruction.Full-thickness eyelid flaps from the lower eyelid are frequently used to repair larger upper eyelid defects. Perfusion monitoring has recently been implemented in several reconstructive surgical procedures, however, perfusion monitoring of a rotational eyelid flap has not yet been described. Bleximenib The authors' employed laser speckle contrast imaging to monitor blood perfusion in a rotational flap from the lower eyelid, used to cover a large tumor defect in the upper eyelid. Perfusion in the flap decreased by only 50% during surgery and was almost completely restored 5 weeks later at flap division (91%). The excellent surgical outcome in the present case is deemed to be the result of satisfactory blood perfusion of the flap.An 84-year-old man presented with a 2-year history of a progressive left-sided ptosis. Examination demonstrated a mechanical ptosis and concentric constriction of the palpebral aperture. CT imaging revealed demonstrated diffuse soft tissue infiltration of the upper and lower eyelids with extension into the anterior orbit. This case was diagnostically challenging because of a history of multiple other primary tumors. However, clinicoradiologic and histopathologic findings were consistent with a diagnosis of primary adnexal signet-ring cell/histiocytoid carcinoma. The patient underwent surgical excision but local recurrence was noted 2 months postoperatively. Langerhans cell histiocytosis (LCH) is a disorder of dendritic cell proliferation that typically involves bone. It can be diagnostically challenging when LCH presents without bony involvement, leading to delays in diagnosis and treatment. In this study, the periocular manifestations of LCH in cases where the underlying orbital bones are not involved are described through a systematic review. A systematic review of the literature was performed to capture all cases of LCH that involved the periocular region but not the underlying orbital bones. These included LCH cases that involved the periocular skin, the ocular surface, and the orbital tissue. The authors also highlight an additional case where LCH presented with periocular edema and multifocal, nodular conjunctival lesions. This review illustrates that LCH rarely presents with periocular infiltration without orbital bone involvement. In these atypical cases, LCH can present as an eyelid mass, a chalazion-like lesi