The rhomboid flap in medial canthal reconstruction

Abstract

Aim - To describe a series of patients who have undergone a medial canthal reconstruction with a rhomboid flap. Methods - A non-comparative interventional case series of 27 patients with medial canthal defects after Mohs excision of medial canthal basal cell carcinomas who underwent reconstruction using a rhomboid-shaped transpositional flap of adjoining skin and subcutaneous tissue. 25 cases were performed under local anaesthesia. The remaining two cases were combined with major lid reconstruction and performed under general anaesthesia. The outcome measures were closure of the defect, the cosmetic result, complications, and re-operations. Results - Primary closure of the defect was achieved in all cases. The cosmetic result was highly satisfactory in all cases. There were no major complications or re-operations. Two cases had minor webbing of the medial upper lid. Conclusions - The rhomboid flap is an effective, quick, and simple technique for medial canthal reconstruction. It provides excellent cosmesis and is associated with minimal complications. It can be modified according to the nature of the periorbital skin and the location, size, and depth of the defect.