OPERATIVE AND PATHOLOGY CASE STUDY Preoperative Diagnosis: Multiple basal cell carcinoma temporal right lower lid Anesthesia: Local Operation: Pentagonal full thickness excision of multiple basal cells right lower lid; right lateral canthoplasty ( surgical repair of the canthus ) Procedure: The patient, a 28-year-old Hispanic male, was brought to the operating room and placed in the supine position. Under nasal prong oxygen and cardiac monitoring, the right lower lid and surrounding area were anesthetized. The right face was prepped in the routine manner. The head and body were draped to expose the right eye. Two, approximately 1.5-2.0 mm, round nodular ulcers centrally cratered, indurated lesions were outlined on the right lower lid not extending above the lateral canthal line. Medial to these lesions was a large milium ( keratin-filled cyst ). A pentagonal incision was outlined incorporating approximately 1 cm of lid margin. A horizontal lateral canthotomy ( surgical division of the slit between the eyelids ) was made and the tissue below it was undermined. The pentagonal incision, with the base being the lid margin, was then excised by outlining with mosquito forceps followed by scissors excision. Hemostasis was achieved with bipolar cautery. The lateral canthal flap was further undermined and the lateral canthal skin incision was extended approximately 0.5 cm temporally. The medial lid margin was then sutured to the lateral canthal ligament. The horizontal incision of the lateral canthotomy was closed and pentagonal lid gap was closed. Tobradex ointment and Telfa pad was placed and ice applied. The patient tolerated the operation well and left the operating room in satisfactory condition.
- Spring '19
- Rousse, Justin R.