Contents

3 BENIGN TUMORS AND RELATED CONDITIONS (continued)

Benign epithelial tumors Papilloma

Seborrheic keratosis (basal cell papilloma, seborrheic wart, senile verruca)

Inverted follicular keratosis (basosquamous cell epidermal tumor, basosquamous cell acanthoma, irritated seborrheic keratosis)

Precancerous epithelial tumors Actinic keratosis (solar keratosis) Dysplasia

Adnexal tumors Sebaceous gland tumors

Congenital sebaceous gland hyperplasia (nevus sebaceous Jadassohn, congenital sebaceous gland hamartoma)

Sebaceous adenoma Tumors of hair follicles

Trichoepithelioma

Calcifying epithelioma of Malherbe (pilomatrixoma)

Trichofolliculoma and trichilemmoma Sweat gland tumors

Syringoma

Eccrine spiradenoma (nodular hidradenoma, clear cell hidradenoma, clear cell myoepithelioma)

Syringocystadenoma papilliferum Xanthelasma

Treatment Amyloidosis

Necrobiotic xanthogranuloma Neurofibromatosis (von Recklinghausen’s

disease) Treatment

References

8 LOWER EYELID RECONSTRUCTION

Small central lid margin defects

Small lateral or medial lid margin defects Defects which extend medial to the punctum Medium lower lid defects extending to the

medial canthal angle

Medium to large lower lid defects Medium defects extending beyond the

medial canthal angle

Medium-sized defects in the lateral aspect of the lower lid

Medium to large lower lid defects Modifications

Alternative method for lateral lower lid defect

Alternative method for medial or central lower lid medium defect

Second stage Hughes procedure References

9 UPPER EYELID RECONSTRUCTION

Eyelid Tumors was written to help the physician diagnose eyelid tumors in the clinical setting and to assist the surgeon who might wish to remove the tumors and repair the eyelid defects. One of the reasons to write the book was that I had seen many patients in my oculoplastic practice with a history of late diagnoses of malignant eyelid tumors. Early diagnosis of eyelid malignancies would lead to better patient care, in the majority of cases. The other reason for writing the text was to share my surgical experiences with other surgeons. Many of the texts in print at the time I wrote the first edition listed a variety of repairs for a specific condition. I, however, chose to discuss only those techniques that gave me the best results. The first section contained many pictures of different lesions with descriptions and anecdotal information. It was my belief that the clinician would look at the book as help in diagnosing the eyelid lesion. By comparing the patient’s lesion with the photos in the book, the physician would be in a better position to make a differential diagnosis and continue with the patient’s care. The care might require further testing, a referral, or definitive treatment.

The first edition was sold out and was not reprinted. Newer techniques of surgical repair were developed since that edition was published. My experience with eyelid tumors increased during the next 15 years and I continue to see patients who present with late diagnoses of eyelid malignancies. My research indicated that eyelid tumors are relatively common in most parts of the world. It is my hope that an expanded second edition will be accepted by an

international audience and result in better medical care for those patients who present with eyelid tumors.

The second edition is divided into two parts. The first deals with the diagnosis of eyelid tumors. Chapter 1 emphasizes the difficulty in the differential diagnosis of malignant tumors because different conditions look similar and the same type of tumor may have a variety of presentations. The next two chapters deal with the presentation and performance of benign and malignant eyelid tumors. By including more than 150 photographs, I intend to show the reader the wide variety of eyelid tumor presentations. Chapter 4 includes the microscopic pathology of malignant eyelid tumors, a subject not included in the first edition. It is written by Dr. Richard Grostern, an ophthalmic pathologist.

The second part of the text discusses the surgical treatment of eyelid tumors and eyelid repair. A new addition to the second edition is the discussion of radiosurgery. This is important in understanding the surgical repair techniques since radiosurgery is my main method of soft tissue dissection. This second part includes newer techniques of eyelid repair. Although there are many methods for repair of eyelid defects, I included only those procedures which I have used and found to be most effective. It is my belief that clinical photos of surgery combined with explicit drawings of these techniques will aid the reader in performing eyelid tumor surgery.

Jay Justin Older