Treatment of Divided Eyelid Nevus With Orbicularis Oculi Myocutaneous Flap: Report of 17 Cases.

[BACKGROUND] Divided eyelid nevus is a rare congenital dermatological abnormality associated with several functional and aesthetic problems. Reconstruction of periorbital defects after resection of the lesions has been an intractable challenge. Also, plastic surgeons are still in the exploration stage regarding the treatment of this disease, because the knowledge about it has only been derived from random case reports and series.

[OBJECTIVE] To evaluate the postoperative effect of advanced orbicularis oculi myocutaneous (OOMC) flap for the treatment of divided eyelid nevus and present our experiences using this technique in our department.

[METHODS] A retrospective study was performed on 17 patients who had undergone treatment of divided eyelid nevus with OOMC flap between December 2012 and January 2018. All patients were treated with advanced OOMC flap. In some cases, flap thinning surgery and/or blepharoplasty was performed in the second stage for symmetry and aesthetic purposes.

[RESULTS] Seventeen patients, aged between 1 and 33 years, were operated. During a follow-up period ranging from 10 to 80 months, all the flaps were viable, and no serious complications were recorded except for partial cilia loss in 6 cases. Four cases developed slightly bloated flap, but after surgical revision by performing flap thinning surgery or/and blepharoplasty in the second stage, they achieved an even better aesthetic reconstruction. Except for the above 4 cases, the other patients stated that no further revision was needed.

[CONCLUSIONS] The OOMC flap is an excellent method for the treatment of divided eyelid nevus, resulting in high functional and aesthetic reconstruction. In some cases, blepharoplasty can be performed in the second stage, which improves the aesthetic outcomes.