Daniela Matuskova’s scientific contributions

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Publications (1)

Fig. 1. Location of the lower eyelid malignant tumors. A, Pretarsal (Type I). B, Preseptal (Type II). C, Eyelid-cheek junction (Type III). D, Multiple lower lid subunits (Type IV). E, Medial canthus. F, Lateral canthus.
Fig. 2. Tenzel semicircular rotational flap. A, Patient with a fullthickness horizontal eyelid defect (90%). The planned flap incision and reconstruction of the posterior lamella by an auricular conchal graft. B, Another patient with a full-thickness pretarsal and preseptal defect (types I and II) involving the lateral canthus (50%). Incisions are performed, and the tarsal strip is separated. C, The tarsal strip is secured to the lateral orbital rim, and the flap is rotated medially to the defect without tension.
Fig. 3. The McGregor flap. A, The planned lower eyelid tumor excision and flap incision. McGregor flap is based on the principle of Z-plasty by transposing two triangular flaps. B, Full-thickness eyelid defect (80%). C, The arms of the Z-plasty form 60° angles, which extend the central arm by 70%. The flap is mobilized in the submuscular layer, reducing tension and improving the scar's final appearance. Reconstruction of the posterior lamella is done using a nasal septum chondromucous graft. D, Final appearance 48 h post-surgery.
Fig. 4. The Mustardé cheek rotation flap. A, Full-thickness lower eyelid defect (100%) (Type IV) after the excision of a spindle cell malignant melanoma. B, Dissection under the superficial musculoaponeurotic system (SMAS), which provides a strong fascial layer to anchor the flap to the periosteum of the orbit or zygomatic bone. Reconstruction of the posterior lamella using a nasal septum chondromucous graft. C, The final appearance 48 h post-surgery. A transposition myocutaneous forehead flap was used to close the lateral periorbital area.
Fig. 9. Rotation and advancement flap in the medial canthus. A, The medial canthal area is a unique part of the face where multiple subunits overlap. This area includes the upper eyelid, lower eyelid, eyebrows, and the sidewall of the nose. Large defect of the medial canthus after the excision of a nodular BCC. A rotation flap incision is made. B, Raising and undermining the flap. C, Raising of the frontal advancement flap with excision of the Burrow triangles. D, Final appearance after suturing the wound without tension. To achieve the best aesthetic outcome, it is essential to replicate the natural depression in the center. Tumors located in the medial canthus pose unique challenges due to their propensity for deep penetration.
Reconstructive techniques for lower eyelid and canthal defects after tumor resection
  • Article
  • Full-text available

January 2024

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25 Reads

Bratislavske Lekarske Listy

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Daniela Matuskova

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Drahomir Palencar

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Background: This prospective study aims to evaluate the demographic and histopathological characteristics of patients who underwent resection of malignant skin tumors of the lower eyelid. It also seeks to assess the size of the defect and outline the management strategies for reconstructing anterior and posterior lamellae. Methods: The study enrolled 87 patients treated between January 1, 2018, and December 31, 2022. The article outlines a reconstructive strategy based on the defect characteristics. Results: The most prevalent type of tumor was basal cell carcinoma (86%), followed by squamous cell carcinoma (8%), malignant melanoma (5%), and Merkel cell carcinoma (1%). There was a slight male preponderance (52%). No significant difference was found in the incidence of lower eyelid malignant tumor between the sex subgroups (p=0.97). The mean age of the patients was 73.52 years (SD=10.582; range 37-92 years). No statistically significant difference in laterality (p=0.108) was observed. A larger tumor size was significantly associated with a higher tumor grade (p=0.008; r=0.926). A significant correlation was identified between the tumor location and the size of the excision (p<0.001). Furthermore, a significant correlation was identified between the histopathological types of tumors and the excision area (p=0.016). Reconstruction of the anterior lamella in small- and medium-sized defects was achieved by using local randomized flaps (61%), primary closure (29%), and skin grafts (10%). For large-sized defects, the anterior lamella was reconstructed by flap (88%) or skin graft (22%). Altogether, posterior lamella was replaced in 25 cases (29%) of all defects using nasal chondromucosa (40%), conchal cartilage (28%), buccal mucosa (8%), periosteal flap (12%), Hewes flap (8%) and Hughes flap (4%). Conclusion: Advanced techniques are necessary when reconstructing a larger lower lid area. In such cases, various subunits must be reconstructed separately to achieve optimal functional and aesthetic outcomes. However, the choice of reconstructive technique mainly depends on the extent of the lid resection (Fig. 9, Ref. 44). Text in PDF www.elis.sk Keywords: defects, eyelid, malignant neoplasms, reconstructive surgical procedures, resection.

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